17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

An unusual case of KBG syndrome with unique oral findings

PubMed Central

Hafiz, Abdul; Mufeed, Abdulla; Ismael, Mohamad; Alam, Mheboob

2015-01-01

KBG syndrome is a condition characterised by macrodontia, neurological disturbance, short stature, a distinct cranio-facial appearance, and skeletal anomalies. The authors describe what appears to be the first case of KBG syndrome reported from the Indian subcontinent. Meticulous evaluation of the dental findings helps to identify such cases which may otherwise remain undiagnosed. Further research is warranted to determine the classic and variant presentations of this condition, with follow-up data providing valuable insights into its natural history and long-term prognosis. PMID:26187867

Relationship between tolerance/intolerance of ambiguity and perceived environmental uncertainty in hospitals.

PubMed

Callahan, P; Young-Cureton, G; Zalar, M; Wahl, S

1997-11-01

1 Many variables may contribute to a nurse's perceptions when working in a changing health care environment, especially in the field of psychiatry. 2 While this study did not find a relationship between tolerance for ambiguity and perceived environmental uncertainty in hospitals, age and educational background appear to be variable, which may warrant further study as ultimately impacting nursing. 3 Research which explores those personality variables which underlie perception would assist nurse administrators in designing interventions, opening new lines of communication, and increasing sensitivity to individual nurse's need in these changing times.

77 FR 65764 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... primarily for use on excursion trains, historical and public relation events, along with possible, but very...), this document provides the public notice that by a document dated February 24, 2012, the Everett... scheduling a public hearing in connection with these proceedings since the facts do not appear to warrant a...

Social competence intervention for youth with Asperger Syndrome and high-functioning autism: an initial investigation.

PubMed

Stichter, Janine P; Herzog, Melissa J; Visovsky, Karen; Schmidt, Carla; Randolph, Jena; Schultz, Tia; Gage, Nicholas

2010-09-01

Individuals with high functioning autism (HFA) or Asperger Syndrome (AS) exhibit difficulties in the knowledge or correct performance of social skills. This subgroup's social difficulties appear to be associated with deficits in three social cognition processes: theory of mind, emotion recognition and executive functioning. The current study outlines the development and initial administration of the group-based Social Competence Intervention (SCI), which targeted these deficits using cognitive behavioral principles. Across 27 students age 11-14 with a HFA/AS diagnosis, results indicated significant improvement on parent reports of social skills and executive functioning. Participants evidenced significant growth on direct assessments measuring facial expression recognition, theory of mind and problem solving. SCI appears promising, however, larger samples and application in naturalistic settings are warranted.

17 CFR 200.30-5 - Delegation of authority to Director of Division of Investment Management.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SECURITIES AND EXCHANGE COMMISSION ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS... indicating that the public interest or the interest of investors warrants that the Commission consider the... not appear to the Director to be necessary in the public interest or the interest of investors that...

Tracking radar advanced signal processing and computing for Kwajalein Atoll (KA) application

NASA Astrophysics Data System (ADS)

Cottrill, Stanley D.

1992-11-01

Two means are examined whereby the operations of KMR during mission execution may be improved through the introduction of advanced signal processing techniques. In the first approach, the addition of real time coherent signal processing technology to the FPQ-19 radar is considered. In the second approach, the incorporation of the MMW radar, with its very fine range precision, to the MMS system is considered. The former appears very attractive and a Phase 2 SBIR has been proposed. The latter does not appear promising enough to warrant further development.

Underage female DUI offenders: personality characteristics, psychosocial stressors, alcohol and other drug use, and driving-risk.

PubMed

Moore, R H

1994-04-01

164 underage female DUI offenders were evaluated on measures of personality, driving-risk, psychosocial stressors, alcohol and other drug use, alcohol abuse, and symptoms of depression. Empirical classification of 10 groups represented five distinct types. 31 youth who were classified as Antisocial exhibited highest rates of alcohol misuse, other drug use, deviant driving behavior, traffic offenses and accidents, and psychosocial stressors. About 56% or 92 appeared to experience impaired functioning serious enough to warrant interventions more intense than educational classes. A measure of driving-risk developed and used in studies of male adults, the Donovan Research Questionnaire, did not appear to differentiate driving-risk among the young women. In contrast to male drivers, who often expressed anger or aggression through driving, most subjects appeared to react to emotion-eliciting stimuli with feelings of low self-worth or dysphoric affect rather than anger. Specialized screening suitable for young female DUI offenders should be considered.

Systematic review of suicide in economic recession

PubMed Central

Oyesanya, Mayowa; Lopez-Morinigo, Javier; Dutta, Rina

2015-01-01

AIM: To provide a systematic update of the evidence concerning the relationship between economic recession and suicide. METHODS: A keyword search of Ovid Medline, Embase, Embase Classic, PsycINFO and PsycARTICLES was performed to identify studies that had investigated the association between economic recession and suicide. RESULTS: Thirty-eight studies met predetermined selection criteria and 31 of them found a positive association between economic recession and increased suicide rates. Two studies reported a negative association, two articles failed to find such an association, and three studies were inconclusive. CONCLUSION: Economic recession periods appear to increase overall suicide rates, although further research is warranted in this area, particularly in low income countries. PMID:26110126

Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs

PubMed Central

Finch, Andrew J.; Moberg, D. Paul; Krupp, Amanda Lawton

2014-01-01

Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance abuse, recovery schools appear to successfully function as continuing care providers reinforcing and sustaining therapeutic benefits gained from treatment. Small size and therapeutic programming allow for a potentially broader continuum of services than currently exists in most of the schools. Recovery schools thus provide a useful design for continuing care warranting further study and policy support. PMID:24591808

Endocrine resistance in breast cancer: new roles for ErbB3 and ErbB4.

PubMed

Sutherland, Robert L

2011-05-20

Endocrine resistance is a major limitation to the successful treatment of estrogen receptor-positive (ER(+)) breast cancer, and the EGFR (epidermal growth factor receptor) and ErbB-2 receptor tyrosine kinases are involved in this process. A recent study now implicates the other two ErbB family members, ErbB-3 and -4. Exposure of ER+ breast cancer cells to the pure antiestrogen, fulvestrant, increased levels of ErbB-3 or ErbB-4 and sensitivity to the growth-stimulatory effects of heregulin β1, a potent ligand for these receptors. Thus, the initial growth-inhibitory effects of fulvestrant appear compromised by cellular plasticity that allows rapid compensatory growth stimulation via ErbB-3/4. Further evaluation of pan-ErbB receptor inhibitors in endocrine-resistant disease appears warranted.

A Decade of Stage Fright Research (1960-1969): A Synthesis.

ERIC Educational Resources Information Center

Munger, Daniel I.

The synthesis of stage fright research by Clevenger (1959) has been widely accepted and used by writers in the speech field. Since 1959, additional research has appeared which warrants an updating of Clevenger's synthesis. Such a followup synthesis is the purpose of this paper. It assumes familiarity with the first article. Measuring stage fright…

77 FR 57116 - Cleveland J. Enmon, Jr., M.D.; Decision and Order

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-17

... from out-of state who did not appear to be in pain), id. at 9-10 (statement of Ocean Care patient that...'' and in fact spurred him to open his own chronic pain management clinic. [Tr. 340, 343]. While Dr... Brunswick's patients were in fact ``legitimate'' pain patients. [Tr. 335]. D. Search Warrant Served on...

Treatment of chronic post-traumatic organic brain syndrome with dextroamphetamine: first reported case.

PubMed

Lipper, S; Tuchman, M M

1976-05-01

In view of its therapeutic efficacy in the treatment of children with minimal brain dysfunction syndrome, dextroamphetamine was administered to a young adult with a chronic organic brain syndrome secondary to cerebral trauma. That D-amphetamine was critical to the resulting marked diminution in confusion, paranoia, and deficit in short term memory was confirmed by the occurrence of a relapse coincident with placebo administration as part of a double blind evaluation. Amitriptylline appeared to potentiate the therapeutic effects of D-amphetamine. The results achieved, although observational and subjective in nature, warrant replication in controlled, quantitative clinical studies.

Uterosomes: Exosomal cargo during the estrus cycle and interaction with sperm.

PubMed

Martin-DeLeon, Patricia Anastasia

2016-01-01

The term "uterosomes" was first used to classify extracellular membrane vesicles released into the uterine luminal fluid. These extracellular vesicles (EVs), varying in sizes, fit the classification of exosomes and microvesicles on the basis of size, the presence of the CD9 biochemical marker, and lateral orientation of the membrane. Uterosomes appear to be formed by the apocrine pathway, similar to other reproductive EVs. In the murine system, the protein cargo carried by uterosomes includes glycosyl phosphatidylinositol (GPI)-linked and transmembrane proteins and these are hormonally regulated, appearing at high levels during proestrus/estrus and only marginally present at diestrus /metestrus. Uterosomes have been shown to deliver proteins in their cargo to sperm, with a functional impact, and are thought to participate in promoting sperm capacitation. Further studies are warranted, particularly those aimed at identifying the contents of their cargo during the estrus and menstrual cycle and the role they play n sperm maturation.

Appearance vs. health reasons for seeking treatment among obese patients with binge eating disorder.

PubMed

Reas, Deborah L; Masheb, Robin M; Grilo, Carlos M

2004-05-01

This study examined reasons for seeking treatment reported by obese patients diagnosed with binge eating disorder (BED). Participants were 248 adults (58 men and 190 women) who met DSM criteria for BED. Participants were recruited through advertisements for treatment studies looking for persons who wanted to "stop binge eating and lose weight." Patients' reasons for seeking treatment were examined with respect to demography (gender and age), obesity (BMI and age of onset), features of eating disorders, and associated psychological functioning (depression and self-esteem). Of the 248 participants, 64% reported health concerns and 36% reported appearance concerns as their primary reason for seeking treatment. Reasons for seeking treatment did not differ significantly by gender. Patients seeking treatment because of appearance-related reasons had lower BMIs than those reporting health-related reasons (34.8 vs. 38.5, respectively), but they reported greater body dissatisfaction, more features of eating disorders, and lower self-esteem. Reasons that prompt treatment seeking among obese individuals with BED reflect meaningful patient characteristics and, therefore, warrant assessment and consideration during treatment planning. Further research is needed to determine whether reasons for treatment seeking among different obese patient groups affect treatment outcomes. Copyright 2004 NAASO

The Construction of Deductive Warrant Derived from Inductive Warrant in Preservice-Teacher Mathematical Argumentations

ERIC Educational Resources Information Center

Tristanti, Lia Budi; Sutawidjaja, Akbar; As'ari, Abdur Rahman; Muskar, Makbul

2016-01-01

This study discusses the construction of deductive warrant derived from inductive warrant in mathematical argumentations expressed by pre-service teacher. In completing a mathematics task, a problem solver needs argumentation to determine, reveal, and support a reasonable solution. A mathematical argumentation can be analyzed by Toulmin scheme…

Characteristics and Mortality of Pneumocystis Pneumonia in Patients With Cushing’s Syndrome: A Plea for Timely Initiation of Chemoprophylaxis

PubMed Central

van Halem, Karlijn; Vrolijk, Lucia; Pereira, Alberto Martin

2017-01-01

Abstract In patients with Cushing’s syndrome, development of Pneumocystis pneumonia (PCP) is associated with extreme cortisol production levels. In this setting, immune reconstitution after abrogation of cortisol excess appears to induce development of symptomatic PCP. The high mortality rate warrants timely initiation of chemoprophylaxis or even preemptive treatment of PCP. PMID:28480275

Internet Gaming Disorder Among Slovenian Primary Schoolchildren: Findings From a Nationally Representative Sample of Adolescents

PubMed Central

Pontes, Halley M.; Macur, Mirna; Griffiths, Mark D.

2016-01-01

Background and aims Since the inclusion of Internet Gaming Disorder (IGD) in the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a tentative disorder, a few psychometric screening instruments have been developed to assess IGD, including the 9-item Internet Gaming Disorder Scale – Short-Form (IGDS9-SF) – a short, valid, and reliable instrument. Methods Due to the lack of research on IGD in Slovenia, this study aimed to examine the psychometric properties of the IGDS9-SF in addition to investigating the prevalence rates of IGD in a nationally representative sample of eighth graders from Slovenia (N = 1,071). Results The IGDS9-SF underwent rigorous psychometric scrutiny in terms of validity and reliability. Construct validation was investigated with confirmatory factor analysis to examine the factorial structure of the IGDS9-SF and a unidimensional structure appeared to fit the data well. Concurrent and criterion validation were also investigated by examining the association between IGD and relevant psychosocial and game-related measures, which warranted these forms of validity. In terms of reliability, the Slovenian version IGDS9-SF obtained excellent results regarding its internal consistency at different levels, and the test appears to be a valid and reliable instrument to assess IGD among Slovenian youth. Finally, the prevalence rates of IGD were found to be around 2.5% in the whole sample and 3.1% among gamers. Discussion and conclusion Taken together, these results illustrate the suitability of the IGDS9-SF and warrants further research on IGD in Slovenia. PMID:27363464

Pharmaceutical sales representatives and physicians: ethical considerations of a relationship.

PubMed

Peppin, J F

1996-02-01

Since their appearance in 1850, Pharmaceutical Sales Representatives (PSR) interactions with physicians have engendered intense emotional responses. The controversy has continued unabated since that time. Arguments in favor of the moral impermissibility of the PSR-physician relationship can be divided into four general categories; (1) influence, (2) patients pay but they do not choose, (3) violation of principlism, and (4) the erosion of the patient-physician relationship. None of the arguments that have thus far been proposed against the moral permissibility of these interactions gives sufficient warrant to avoid them (or pursue them). It may be the case that PSR-physician interactions place the patient-physician relationship in jeopardy. This would constitute enough warrant, from a pragmatic perspective, to shun such relationships. However, no research supports this contention. A careful evaluation of the literature leaves one ambivalent at best.

Evaluating Health Advice in a Web 2.0 Environment: The Impact of Multiple User-Generated Factors on HIV Advice Perceptions.

PubMed

Walther, Joseph B; Jang, Jeong-Woo; Hanna Edwards, Ashley A

2018-01-01

Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.

Moving base simulation of an integrated flight and propulsion control system for an ejector-augmentor STOVL aircraft in hover

NASA Technical Reports Server (NTRS)

Mcneill, Walter, E.; Chung, William W.; Stortz, Michael W.

1995-01-01

A piloted motion simulator evaluation, using the NASA Ames Vertical Motion Simulator, was conducted in support of a NASA Lewis Contractual study of the integration of flight and propulsion systems of a STOVL aircraft. Objectives of the study were to validate the Design Methods for Integrated Control Systems (DMICS) concept, to evaluate the handling qualities, and to assess control power usage. The E-7D ejector-augmentor STOVL fighter design served as the basis for the simulation. Handling-qualities ratings were obtained during precision hover and shipboard landing tasks. Handling-qualities ratings for these tasks ranged from satisfactory to adequate. Further improvement of the design process to fully validate the DMICS concept appears to be warranted.

NASA-EPA automotive thermal reactor technology program

NASA Technical Reports Server (NTRS)

Blankenship, C. P.; Hibbard, R. R.

1972-01-01

The status of the NASA-EPA automotive thermal reactor technology program is summarized. This program is concerned primarily with materials evaluation, reactor design, and combustion kinetics. From engine dynamometer tests of candidate metals and coatings, two ferritic iron alloys (GE 1541 and Armco 18-SR) and a nickel-base alloy (Inconel 601) offer promise for reactor use. None of the coatings evaluated warrant further consideration. Development studies on a ceramic thermal reactor appear promising based on initial vehicle road tests. A chemical kinetic study has shown that gas temperatures of at least 900 K to 1000 K are required for the effective cleanup of carbon monoxide and hydrocarbons, but that higher temperatures require shorter combustion times and thus may permit smaller reactors.

Levodopa in Huntingtons chorea.

PubMed

Sishta, S K; Templer, D I

1976-05-08

Sixteen patients with Huntington's chorea were treated for periods as long as 8 months with levodopa. The condition of none of the patients improved; in fact, there appeared to be an exacerbation of chorea and dementia in addition to undesirable behavioural changes. Therefore, future use of levodopa in these patients is not warranted. The postulated association of low homovanillic acid values in cerebrospinal fluid and favourable response to levodopa therapy was not borne out.

Health Effects of Embedded Depleted Uranium Fragments.

DTIC Science & Technology

1996-11-15

18]. The metabolic (approximately 99.8%). DU emits alpha (a), beta models required to estimate the chemical and radio- (3), and weak gamma ( y ...for the large-scale screening of patients who choosing an animal model for carcinogenesis stud- may be at increased risk of developing cancer . ies...appears warranted biomarkers for neoplastic tissues. since it is likely to provide better assurance of detecting changes that are associated with Cancer

Targeting interleukin-1β in CAPS (cryopyrin-associated periodic) syndromes: what did we learn?

PubMed

Koné-Paut, Isabelle; Piram, Maryam

2012-11-01

CAPS is the prototype of an IL-1β driven auto inflammatory disorder. Features of recurrent systemic inflammation compromises patient's quality of life, and may reduce life expectancy by inducing definite organ damage. Recent treatment targeting IL-1 have shown dramatic effect on patient's clinical symptoms and quality of life. Anakinra was first used successfully in treating small series of patients with all CAPS phenotypes. Two pivotal randomized placebo-controlled studies allowed licensing of rilonacept and canakinumab as orphan drugs for CAPS patients. The use of anti-IL-1 drugs in CAPS is still relatively new, and their effect on a long term is not well known. As we can suppress the clinical symptoms of patients with CAPS, important questions remain regarding the full effect of anti-IL-1 treatment on organ involvement and their potential ability to prevent them. As important variations of treatment doses and schedules appear in reaching effectiveness, pharmacologic studies are still warranted to determine a potential diffusion of anti-IL-1 drugs in the fluids and tissues. More studies evaluating the efficacy and safety of anti-IL-1 drugs given in patients before 2 years of age are warranted, since it is believed that the earliest treatment could avoid secondary CAPS complications to develop. Copyright © 2012 Elsevier B.V. All rights reserved.

Recent developments in research and treatment for social phobia (social anxiety disorder).

PubMed

Cottraux, Jean

2005-01-01

This review covers three themes of research that brought fresh data useful for clinical practice in a handicapping anxiety disorder: social phobia. Recent findings deriving from basic biological research, new forms of psychological therapies, and recent psychopharmacology controlled trials are reviewed. The basic neuroimaging research suggests that greater activation of the amygdala to novel versus familiar faces may be an underlying trait marker for social phobia. Social phobia may represent a phenotype that expresses a genetically driven trait of social withdrawal, which may be related to infantile inhibited temperament (Kagan's syndrome). The development of virtual reality therapy as therapeutic tool for social phobia appeared promising in one controlled, but not randomized, study. A controlled study suggests that social phobias in children can be effectively treated with cognitive behavioural therapy. This represents an extension of the work done with adults. Venlafaxine appears an effective short-term treatment for social anxiety disorder in two controlled studies. A new compound, pregabalin, appeared clearly effective in a positive controlled study. This trial marks the advent of a new pharmacological lineage for social phobia. Both venlafaxine and pregabalin, however, have been studied in short-term studies. Longer follow-up and relapse prevention studies are warranted. Neuroimaging research points to a temperamental basis for social phobia. Virtual reality therapy is an emerging tool to carry out exposure treatment. Group cognitive behavioural therapy can be extended successfully to children. Venlafaxine and pregabalin have a proven short-term effectiveness in social phobia.

A body image and disordered eating intervention for women in midlife: a randomized controlled trial.

PubMed

McLean, Siân A; Paxton, Susan J; Wertheim, Eleanor H

2011-12-01

This study examined the outcome of a body image and disordered eating intervention for midlife women. The intervention was specifically designed to address risk factors that are pertinent in midlife. Participants were 61 women aged 30 to 60 years (M = 43.92, SD = 8.22) randomly assigned to intervention (n = 32) or (delayed treatment) control (n = 29) groups. Following an 8-session facilitated group cognitive behavioral therapy-based intervention, outcomes from the Body Shape Questionnaire; Eating Disorder Examination Questionnaire; Body Image Avoidance Questionnaire; Physical Appearance Comparison Scale; Sociocultural Attitudes Towards Appearance Scale, Internalization subscale; measures of appearance importance, cognitive reappraisal, and self-care; Dutch Eating Behavior Questionnaire; and Kessler Psychological Distress Scale were compared for statistical and clinical significance from baseline to posttest and 6-month follow-up. Following the intent-to-treat principle, mixed-model analyses with a mixed within-between design demonstrated that the intervention group had large improvements that were statistically significantly different from the control group in body image, disordered eating, and risk factor variables and that were maintained at 6-month follow-up. Furthermore, the improvements were also of clinical importance. This study provides support for the efficacy of an intervention to reduce body image and eating concerns in midlife women. Further research into interventions tailored for this population is warranted.

A Randomized, Controlled Trial of Wholistic Hybrid Derived From Eye Movement Desensitization and Reprocessing and Emotional Freedom Technique (WHEE) for Self-Treatment of Pain, Depression, and Anxiety in Chronic Pain Patients

PubMed Central

Benor, Daniel; Rossiter-Thornton, John; Toussaint, Loren

2016-01-01

In this pilot study, a convenience sample of 24 chronic pain patients (17 with chronic fatigue syndrome/fibromyalgia) were randomized into WHEE treatment and wait-list control groups for 6 weeks. Assessments of depression, anxiety, and pain were completed before, during, and at 1 and 3 months after treatment. Wait-listed patients then received an identical course of WHEE and assessments. WHEE decreased anxiety (P < .5) and depression (P < .05) compared with the control group. The wait-list-turned-WHEE assessments demonstrated decreased pain severity (P < .05) and depression (P < .04) but not pain interference or anxiety. WHEE appears a promising method for pain, anxiety, and depression in patients with chronic pain, compared to standard medical care alone. Though a small pilot study, the present results suggest that further research appears warranted. An incidental finding was that a majority of patients with chronic pain had suffered psychological trauma in childhood and/or adulthood. PMID:27432773

DRD2 Promoter Region Variation Predicts Antipsychotic-Induced Weight Gain in First Episode Schizophrenia

PubMed Central

Lencz, Todd; Robinson, Delbert G.; Napolitano, Barbara; Sevy, Serge; Kane, John M.; Goldman, David; Malhotra, Anil K.

2010-01-01

Many antipsychotic medications carry a substantial liability for weight gain, and one mechanism common to all antipsychotics is binding to the dopamine D2 receptor. We therefore examined the relationship between −141C Ins/Del (rs1799732), a functional promoter region polymorphism in DRD2, and antipsychotic-induced weight gain in 58 first episode schizophrenia patients enrolled in a randomized trial of risperidone (RIS) vs. olanzapine (OLZ). Carriers of the deletion allele (n=29) were compared to Ins/Ins homozygotes (non-carriers, n=29) in a mixed model encompassing 10 weight measurements over 16 weeks. Deletion allele carriers demonstrated significantly more weight gain after 6 weeks of treatment regardless of assigned medication. While deletion carriers were prescribed higher doses of OLZ (but not RIS), dose did not appear to account for the genotype effects on weight gain. Given previous evidence that deletion carriers demonstrate reduced symptom response to medication, additional study of appropriate treatment options for these patients appears warranted. PMID:20664489

ASSESSMENT OF THE POTENTIAL FOR TRANSPORT OF ...

EPA Pesticide Factsheets

Dioxins are very toxic contaminants and warrant study under a variety of experimental conditions. Studies were performed to evaluate the mobility of several of the dioxins in both soil columns as well as in batch experiments. The studies showed that the amount of chlorination did not necessarily control the partitioning of the dioxins, as expected, but also suggested that the structure or location where the Cl ion was attached to the benzene ring modified the hydrophobicity of the compound. Studies were performed with a variety of cosolvents which might mediate the movement of the Dioxin. The observed modification in mobility was consistent with existing theory for enhanced mobility with truly miscible solvents. Experimental data appears to show reversibility in the sorption process, but significantly limited by kinetics with 30 to 50 days reguired to release 50-90% of the contaminant. present information

Levodopa in Huntingtons chorea.

PubMed Central

Sishta, S. K.; Templer, D. I.

1976-01-01

Sixteen patients with Huntington's chorea were treated for periods as long as 8 months with levodopa. The condition of none of the patients improved; in fact, there appeared to be an exacerbation of chorea and dementia in addition to undesirable behavioural changes. Therefore, future use of levodopa in these patients is not warranted. The postulated association of low homovanillic acid values in cerebrospinal fluid and favourable response to levodopa therapy was not borne out. PMID:131644

Review of Grit and Resilience Literature within Health Professions Education

PubMed Central

Cain, Jeff

2018-01-01

Objective. To review literature pertaining to grit and resilience in health professions education. Findings. There is significant interest in grit and resilience throughout the health professions, but little has been published with regard to pharmacy. Although there are methodological issues with defining and measuring grit and resilience, several studies have shown relationships between the constructs and personal and academic well-being. Educational interventions aimed at increasing grit and resilience have produced mixed results. Developing protective factors appears to be the most common approach in helping students become more resilient. Summary. Literature pertaining to grit and resilience reveals that the terms are nuanced, complex, and difficult to measure and understand. Regardless, the general characteristics associated with grit and resilience are of interest to educators and warrant further study. PMID:29606705

Investigation of factors affecting the heater wire method of calibrating fine wire thermocouples

NASA Technical Reports Server (NTRS)

Keshock, E. G.

1972-01-01

An analytical investigation was made of a transient method of calibrating fine wire thermocouples. The system consisted of a 10 mil diameter standard thermocouple (Pt, Pt-13% Rh) and an 0.8 mil diameter chromel-alumel thermocouple attached to a 20 mil diameter electrically heated platinum wire. The calibration procedure consisted of electrically heating the wire to approximately 2500 F within about a seven-second period in an environment approximating atmospheric conditions at 120,000 feet. Rapid periodic readout of the standard and fine wire thermocouple signals permitted a comparison of the two temperature indications. An analysis was performed which indicated that the temperature distortion at the heater wire produced by the thermocouple junctions appears to be of negligible magnitude. Consequently, the calibration technique appears to be basically sound, although several practical changes which appear desirable are presented and discussed. Additional investigation is warranted to evaluate radiation effects and transient response characteristics.

The neuropsychology of repeated 1- and 3-meter springboard diving among college athletes.

PubMed

Zillmer, Eric A

2003-01-01

This study examined the neuropsychological effects of repeated springboard diving. It was hypothesized that the impact velocity, which can range from 20 to 30 mph, and accompanying deceleration in the water may lead to concussions and affect the diver's cognitive function. Six varsity National Collegiate Athletic Association Division 1 springboard divers participated in the study. Each diver performed a total of 50 practice dives from either the 1- or 3-m springboard. After each set of 10 dives, the participants were immediately evaluated at poolside using the Symbol Digit Modalities Test, the Stroop Color Word Test, and the Trail Making Test B. Baseline testing revealed, consistent with their athletic specialty, clear neurocognitive strengths among the divers on tests sensitive to proprioception, motor speed, and visual-spatial organization. Results from the serial assessments indicated no detectable neuropsychological deficits among competitive divers compared to baseline testing. Skilled diving at the collegiate level appears to be a safe sport and water appears to present the perfect medium for gradual deceleration. More studies, however, are warranted for 5-, 7.5-, and 10-m platform diving since the impact velocity of the diver from these heights is higher.

Sibship size, birth order, family structure and childhood mental disorders.

PubMed

Carballo, Juan J; García-Nieto, Rebeca; Alvarez-García, Raquel; Caro-Cañizares, Irene; López-Castromán, Jorge; Muñoz-Lorenzo, Laura; de Leon-Martinez, Victoria; Baca-García, Enrique

2013-08-01

The aim of this study was to determine the role that birth order, sibship size and family structure have as risk factors in the development of common childhood mental disorders. A case-control study design was conducted (N = 16,823). The group under study consisted of all those subjects who had consulted with a psychiatrist/psychologist and had received a clinical diagnosis at public mental health centres within the Region of Madrid (Spain), between 1980 and 2008. A multiple logistic regression was used to explore the independent association with each diagnosis: emotional disorders (ED) with onset specific to childhood, attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), mental retardation (MR), and pervasive developmental disorder (PDD). Birth order and family structure significantly predicted the risk of being diagnosed with ED or ADHD. In addition, sibship size and sex predicted the risk of being diagnosed with a childhood mental disorder. We concluded that being the middle child and living with both biological parents appear to be protective factors against the development of ED or ADHD. Living in large families appears to increase the risk of receiving a CD, MR, or PDD diagnosis. Further research is warranted.

Blastocystis hominis revisited.

PubMed Central

Stenzel, D J; Boreham, P F

1996-01-01

Blastocystis hominis is a unicellular organism found commonly in the intestinal tract of humans and many other animals. Very little is known of the basic biology of the organism, and controversy surrounds its taxonomy and pathogenicity. There morphological forms (vacuolar, granular, and ameboid) have been recognized, but recent studies have revealed several additional forms (cyst, avacuolar, and multivacuolar). The biochemistry of the organism has not been studied to any extent, and organelles and structures of unknown function and composition are present in the cells. Several life cycles have been proposed but not experimentally validated. The form used for transmission has not been defined. Infections with the organism are worldwide and appear in both immunocompetent and immunodeficient individuals. Symptoms generally attributed to B. hominis infection are nonspecific, and the need for treatment is debated. If treatment appears warranted, metronidazole is suggested as the drug of choice, although failures of this drug in eradicating the organism have been reported. Infection is diagnosed by light microscopic examination of stained smears or wet mounts of fecal material. Most laboratories identify B. hominis by observing the vacuolar form, although morphological studies indicate that other forms, such as the cyst form and multivacuolar form, also should be sought for diagnosis. PMID:8894352

Occupational Therapists' Views of Nussbaum's Life Capability: An Exploratory Study.

PubMed

Mousavi, Tahmineh; Dharamsi, Shafik; Forwell, Susan; Dean, Elizabeth

2015-10-01

Life Capability is the first and most fundamental of Nussbaum's 10 Central Human Functional Capabilities (CHFCs). This capability refers to a person having a quality life of normal duration. The purpose of this study was to explore the views' of occupational therapists about Life Capability, specifically, their perspectives of this capability and its perceived relevance to practice. Semi-structured interviews with 14 occupational therapists in British Columbia, Canada, were conducted and thematically analyzed. Within this Canadian context, three themes emerged regarding occupational therapists' views about Life Capability: basic human right, quality of life, and longevity. Occupational therapists appear to view Life Capability as being consistent with the values of the occupational therapy profession. Nussbaum's other CHFCs warrant study to explore the degree to which the Capabilities Approach could complement existing occupational therapy theories, science, and practice. © The Author(s) 2015.

Young Patients Detained under the Lieutenant Governor Warrant in Ontario.

ERIC Educational Resources Information Center

Phillips, Michael S.; Spears, Christopher

1987-01-01

Studied 24 patients being held on lieutenant governor warrants in Ontario, Canada who had been placed on warrants as juveniles. Found subjects to be predominantly male with histories of psychiatric illnesses, diagnosed mainly as antisocial personality, and to have been found not guilty by reason of insanity on charges primarily of murder or…

Torsion Tests of Stiffened Circular Cylinders

NASA Technical Reports Server (NTRS)

Moore, R L; Wescoat, C

1944-01-01

The design of curved sheet panels to resist shear involves a consideration of several factors: the buckling resistance of the sheet, the stress at which buckling becomes permanent, and the strength which may be developed beyond the buckling limit by tension-field action. Although some experimental as well as theoretical work has been done on the buckling and tension-field phases of this problem, neither of these types of action appears to be very well understood. The problem is of sufficient importance from the standpoint of aircraft design, it is believed, to warrant further experimental investigation. This report presents the results of the first series of torsion tests of stiffened circular cylinders to be completed in connection with this study at Aluminum Research Laboratories. (author)

The Measure of Sickle Cell Stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study.

PubMed

Bediako, Shawn M; Lanzkron, Sophie; Diener-West, Marie; Onojobi, Gladys; Beach, Mary C; Haywood, Carlton

2016-05-01

Research about the influence of stigma on health outcomes in sickle cell disease is limited. We administered the recently developed Measure of Sickle Cell Stigma to 262 patients in the United States. The Measure of Sickle Cell Stigma yielded very good internal consistency and four interpretable factors. Significant associations among stigma, pain-related healthcare utilization, and perceived disease severity were observed for three of the four stigma factors (F range = 2.78-5.44). The Measure of Sickle Cell Stigma appears to be a useful tool for measuring disease-specific stigma among adults living with sickle cell disease, and further assessment of its clinical utility is warranted. © The Author(s) 2014.

Use of warrants for breath test refusal : case studies

DOT National Transportation Integrated Search

2007-10-01

This study investigated the use of warrants to obtain blood samples from drivers arrested for alcohol-impaired driving and who refuse to provide breath samples when requested to do so by law enforcement officers. Case studies were conducted in four S...

Plasma Cytokine Levels During Long-Duration Spaceflight

NASA Technical Reports Server (NTRS)

Crucian, Brian E.; Zwart, Sara R.; Quiriarte, Heather A.; Smith, Scott M.; Sams, Clarence F.

2011-01-01

Reduced T cell, granulocyte, NK and monocyte function have all been reported following both long and short duration spaceflight, however these data indicate crews are generally not experiencing inflammatory or adaptive immune activation during spaceflight. There appear to be varied individual crew responses, and specific relationships between cytokines and markers of iron status and muscle turnover that warrant further evaluation. Increases in growth factors and chemokines may indicate other types of adaptation occurring during spaceflight, such as attempts to overcome diminished immunocyte function.

Mod 1 wind turbine generator failure modes and effects analysis

NASA Technical Reports Server (NTRS)

1979-01-01

A failure modes and effects analysis (FMEA) was directed primarily at identifying those critical failure modes that would be hazardous to life or would result in major damage to the system. Each subsystem was approached from the top down, and broken down to successive lower levels where it appeared that the criticality of the failure mode warranted more detail analysis. The results were reviewed by specialists from outside the Mod 1 program, and corrective action taken wherever recommended.

Comparative biology of the neuronal ceroid-lipofuscinoses (NCL): an overview.

PubMed

Jolly, R D

1995-06-05

Multiple forms of ceroid-lipofuscinosis occur in human beings and animals. They are characterized by brain and retinal atrophy associated with selective necrosis of neurons. This neurodegenerative disease appears associated with the disease process rather than storage of fluorescent lipopigment per se, and there is now growing evidence that pathogenesis may involve mitochondria rather than a primary defect of lysosomal catabolism. Of the forms of ceroid-lipofuscinosis studied, most but not all reflect accumulation of subunit c of mitochondrial ATP synthase. If there is a common denominator between all forms other than the presence of fluorescent lipopigment, then it may be the accumulation of hydrophobic protein. Analogous diseases in animals can be expected to reflect the same spectrum of biochemical changes, and they warrant in-depth study to help understand the pathogenesis and heterogeneity of the group.

Doxorubicin and deracoxib adjuvant therapy for canine splenic hemangiosarcoma: A pilot study

PubMed Central

Kahn, S. Anthony; Mullin, Christine M.; de Lorimier, Louis-Philippe; Burgess, Kristine E.; Risbon, Rebecca E.; Fred, Rogers M.; Drobatz, Kenneth; Clifford, Craig A.

2013-01-01

Canine hemangiosarcoma (HSA) is a highly malignant tumor for which standard chemotherapy has done little to substantially improve survival. Cyclooxygenase-2 (Cox-2) plays a role in the formation, growth, and metastasis of tumors and inhibitors have demonstrated therapeutic benefit with certain canine cancers. In this prospective study, 21 dogs received adjuvant therapy combining the selective Cox-2 inhibitor deracoxib with doxorubicin, following splenectomy for HSA. The combination was well-tolerated with only low-grade gastrointestinal and hematologic toxicities noted. An overall median survival of 150 days (range; 21 to 1506 days) was noted. Although there was no significant difference in survival based upon stage of disease, dogs with stage III HSA (n = 11) had a median survival of 149 days, which appears to be longer than previously reported. Further studies are warranted to evaluate the potential benefit of Cox-2 inhibitors in the treatment of canine HSA. PMID:23997259

A preliminary investigation of bird classification by Doppler radar

NASA Technical Reports Server (NTRS)

Martinson, L. W.

1973-01-01

A preliminary study of the application of Doppler radar to the classification of birds is reported. The desirability for improvements in bird classification stems primarily from the hazards they present to jet aircraft in flight and in the vicinity of airports. A secondary need exists in the study of bird migration. The wing body and tail motion of a bird in flight reflect signals which, when analyzed properly present a signature of wing beat pattern which is unique for each bird species. Although the results of this investigation did not validate the feasibility of classifying bird species, they do indicate that a more thorough investigation is warranted. Certain gross characteristics such as wing beat rates, multiple bird patterns, and bird maneuverability, were indicated clearly in the results. Large birds with slow wing beat rates appear to be the most optimum subject for further study with the X-band Doppler radar used in this investigation.

Is there a difference in survival between men and women suffering in-hospital cardiac arrest?

PubMed

Israelsson, Johan; Persson, Carina; Strömberg, Anna; Arestedt, Kristofer

2014-01-01

To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival. Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted. This registry study included 286 CAs. To investigate if sex was associated with survival, logistic regression analyses were performed. The proportion of CA with a resuscitation attempt compared to CA without resuscitation was higher among men. There were no associations between sex and survival when controlling for previously known predictors and interaction effects. Sex does not appear to be a predictor for survival among patients suffering CA where resuscitation is attempted. The difference regarding proportion of resuscitation attempts requires more attention. It is important to consider possible interaction effects when studying the sex perspective. Copyright © 2014 Elsevier Inc. All rights reserved.

Smoking in film in New Zealand: measuring risk exposure.

PubMed

Gale, Jesse; Fry, Bridget; Smith, Tara; Okawa, Ken; Chakrabarti, Anannya; Ah-Yen, Damien; Yi, Jesse; Townsend, Simon; Carroll, Rebecca; Stockwell, Alannah; Sievwright, Andrea; Dew, Kevin; Thomson, George

2006-10-04

Smoking in film is a risk factor for smoking uptake in adolescence. This study aimed to quantify exposure to smoking in film received by New Zealand audiences, and evaluate potential interventions to reduce the quantity and impact of this exposure. The ten highest-grossing films in New Zealand for 2003 were each analysed independently by two viewers for smoking, smoking references and related imagery. Potential interventions were explored by reviewing relevant New Zealand legislation, and scientific literature. Seven of the ten films contained at least one tobacco reference, similar to larger film samples. The majority of the 38 tobacco references involved characters smoking, most of whom were male. Smoking was associated with positive character traits, notably rebellion (which may appeal to adolescents). There appeared to be a low threshold for including smoking in film. Legislative or censorship approaches to smoking in film are currently unlikely to succeed. Anti-smoking advertising before films has promise, but experimental research is required to demonstrate cost effectiveness. Smoking in film warrants concern from public health advocates. In New Zealand, pre-film anti-smoking advertising appears to be the most promising immediate policy response.

Embryonic vaccines against cancer: an early history.

PubMed

Brewer, Bradley G; Mitchell, Robert A; Harandi, Amir; Eaton, John W

2009-06-01

Almost 100 years have passed since the seminal observations of Schöne showing that vaccination of animals with fetal tissue would prevent the growth of transplantable tumors. Many subsequent reports have affirmed the general idea that immunologic rejection of transplantable tumors, as well as prevention of carcinogenesis, may be affected by vaccination with embryonic/fetal material. Following a decade of intense research on this phenomenon during approximately 1964-1974, interest appears to have waned. This earlier experimental work may be particularly pertinent in view of the rising interest in so-called cancer stem cells. We believe that further work - perhaps involving the use of embryonic stem cells as immunogens - is warranted and that the results reviewed herein support the concept that vaccination against the appearance of cancers of all kinds is a real possibility.

Anarbylus switaki Murphy: an addition to the herpetofauna of the United States with comments on relationships with Coleonyx

USGS Publications Warehouse

Fritts, T.H.; Snell, H.L.; Martin, R.L.

1982-01-01

Anarbys switaki, a species previously known only from Baja California Sur, Mexico, occurs in eastern San Diego and southwestern Imperial Counties in California. In California, specimens tend to have continuous transverse bars on the body, are lighter in color, and more slender in body form than in southern Baja California. California populations appear to be confined to extremely rocky habitats in desert foothill situations between 200 and 600 m. The species appears to be secretive, and occurs in low densities within rock crevices and subterranean cavities. The morphological gap between Anarbylus and Coleonyx species may not warrant generic recognition. Anarbylus is part of a diverse lizard fauna in southern California and occurs in sympatry with 15 lizard species in a small area of southern California.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landau, D.; Shalev, H.; Carmi, Rivka

The infantile variant of Bartter syndrome (IBS) is usually associated with maternal polyhydramnios, premature birth, postnatal polyuria and hypokalemic hypochloremic metabolic alkalosis and a typical appearance. IBS is thought to be an autosomal recessive trait. Several congenital tubular defects are associated with sensorineural deafness (SND). However, an association between the IBS and SND has not been reported so far. Here we describe 5 children of an extended consanguineous Bedouin family with IBS and SND. In 3 of the cases, the typical electrolyte imbalance and facial appearance were detected neonatally. SND was detected as early as age 1 month, suggesting eithermore » coincidental homozygotization of 2 recessive genes or a pleiotropic effect of one autosomal recessive gene. This association suggests that evaluation of SND is warranted in every case of IBS. 35 refs., 2 figs., 2 tabs.« less

Crash history after installation of traffic signals : warranted vs. unwarranted.

DOT National Transportation Integrated Search

2008-01-01

The objective of this study was to determine the change in crash history at intersections after installation of a traffic signal. Signals installed based on the warrants from an engineering study resulted in a decrease in angle collisions with an inc...

Preventing postsurgical dissatisfaction syndrome after rhinoplasty with propranolol: a pilot study.

PubMed

Gruber, Ronald P; Roberts, Christa; Schooler, Wesley; Pitman, Roger K

2009-03-01

Rhinoplasty patients are commonly anxious about their result when the splint is removed. A small group of them, however, are overtly unhappy with their appearance despite objectively satisfactory early results, cannot be reassured about their favorable long-term prognosis, and remain dissatisfied despite objectively satisfactory end results. The authors have termed this symptom complex "postsurgical dissatisfaction syndrome." In these patients, it seems that persistence of the original negative image of their appearance at the time of splint removal fails to yield to an improved self-image as healing progresses. The authors theorized that the syndrome is analogous to the persistence of negative emotional memories seen in posttraumatic stress disorder. In trauma-exposed patients, the beta-adrenergic blocker propranolol, when given within a few hours of the traumatic event, may reduce the subsequent emotional strength of the traumatic memory. The authors hypothesized that giving propranolol to postrhinoplasty patients with the above early symptomatology would reduce the likelihood of postsurgical dissatisfaction syndrome. A retrospective review of 1000 consecutive rhinoplasty patients identified 11 with early symptomatology. Of these 11 (not taking propranolol), nine (82 percent) developed postsurgical dissatisfaction syndrome. In addition, a prospective study was performed of nine additional patients with the same early symptomatology who were immediately treated with propranolol. In contrast, only three developed postsurgical dissatisfaction syndrome (p < 0.04). Results of a randomized, double-blind, placebo-controlled study of 50 additional postrhinoplasty patients suggests that propranolol's effect is not due to anxiolysis. Propranolol given immediately after splint removal in anxious, unhappy cosmetic surgery patients may prevent postsurgical dissatisfaction syndrome. A double-blind study appears warranted.

Is a sphygmomanometer a valid and reliable tool to measure the isometric strength of hip muscles? A systematic review.

PubMed

Toohey, Liam Anthony; De Noronha, Marcos; Taylor, Carolyn; Thomas, James

2015-02-01

Muscle strength measurement is a key component of physiotherapists' assessment and is frequently used as an outcome measure. A sphygmomanometer is an instrument commonly used to measure blood pressure that can be potentially used as a tool to assess isometric muscle strength. To systematically review the evidence on the reliability and validity of a sphygmomanometer for measuring isometric strength of hip muscles. A literature search was conducted across four databases. Studies were eligible if they presented data on reliability and/or validity, used a sphygmomanometer to measure isometric muscle strength of the hip region, and were peer reviewed. The individual studies were evaluated for quality using a standardized critical appraisal tool. A total of 644 articles were screened for eligibility, with five articles chosen for inclusion. The use of a sphygmomanometer to objectively assess isometric muscle strength of the hip muscles appears to be reliable with intraclass correlation coefficient values ranging from 0.66 to 0.94 in elderly and young populations. No studies were identified that have assessed the validity of a sphygmomanometer. The sphygmomanometer appears to be reliable for assessment of isometric muscle strength around the hip joint, but further research is warranted to establish its validity.

The Social Construction of Warranting Evidence in Two Classrooms

ERIC Educational Resources Information Center

Weyand, Larkin; Goff, Brent; Newell, George

2018-01-01

This study examines how instructional conversations revealed the ways two teachers' argumentative epistemologies (ideational and social process) shaped literacy events focused on the warranting of evidence. A microethnographic study of the literacy events within each teacher's respective instructional unit revealed that each teacher's epistemology…

Japanese plums (Prunus salicina Lindl.) and phytochemicals--breeding, horticultural practice, postharvest storage, processing and bioactivity.

PubMed

Fanning, Kent J; Topp, Bruce; Russell, Dougal; Stanley, Roger; Netzel, Michael

2014-08-01

Previous reviews of plum phytochemical content and health benefits have concentrated on the European plum, Prunus domestica L. However, the potential bioactivity of red- and dark red-fleshed Japanese plums, Prunus salicina Lindl., so-called blood plums, appears to warrant a significant increase in exposure, as indicated in a recent review of the whole Prunus genus. Furthermore, Japanese plums are the predominant plum produced on an international basis. In this review the nutrient and phytochemical content, breeding, horticultural practice, postharvest treatment and processing as well as bioactivity (emphasising in vivo studies) of Japanese plum are considered, with a focus on the anthocyanin content that distinguishes the blood plums. © 2014 State of Queensland Journal of the Science of Food and Agriculture © 2014 Society of Chemical Industry.

Prevalence of methicillin-resistant Staphylococcus aureus colonization in horses in Saskatchewan, Alberta, and British Columbia

PubMed Central

Tokateloff, Nathalie; Manning, Stephen T.; Weese, J. Scott; Campbell, John; Rothenburger, Jamie; Stephen, Craig; Bastura, Vanessa; Gow, Sheryl P.; Reid-Smith, Richard

2009-01-01

This study estimated the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in nasal swabs of 458 horses in western Canada. The rate of colonization was 1.3% ± 5.84% [95% confidence interval (CI)], a rate similar to those reported elsewhere. Colonization tended to be transient and seemed unrelated to stress or administration of antimicrobials. Five of the 6 isolates were Canadian epidemic MRSA-5, a human clone that appears to predominate in horses in North America. The other isolate was spa type 539 (t034), a sequence type 398 strain, and this is the first report of this clone in horses in North America. Surveillance is warranted because of the potential of MRSA to cause disease in horses and humans. PMID:20119542

Cryptosporidiosis - an occupational risk and a disregarded disease in Estonia.

PubMed

Lassen, Brian; Ståhl, Marie; Enemark, Heidi L

2014-06-05

Cases of cryptosporidiosis have not been officially reported in Estonia after the year 2000, and the disease appears to be either under-diagnosed or under-reported. Based on a human case of cryptosporidiosis contracted during faecal sampling in dairy farms, cattle considered to be sources of infection were analysed for Cryptosporidium spp. by a modified Ziehl Neelsen technique and molecular typing. C. parvum subtype IIaA16G1R1 was detected from the human case and from calves from one of nine farms enrolled in the study providing strong circumstantial evidence of zoonotic transmission from calves to humans. Cryptosporidiosis presents an occupational risk to people with cattle contact, and may also be a risk to the human population in general. Thus increased public and medical awareness is warranted.

Microbial ecology measurement system

NASA Technical Reports Server (NTRS)

1972-01-01

The sensitivity and potential rapidity of the PIA test that was demonstrated during the feasibility study warranted continuing the effort to examine the possibility of adapting this test to an automated procedure that could be used during manned missions. The effort during this program has optimized the test conditions for two important respiratory pathogens, influenza virus and Mycoplasma pneumoniae, developed a laboratory model automated detection system, and investigated a group antigen concept for virus detection. Preliminary tests on the handling of oropharygeal clinical samples for PIA testing were performed using the adenovirus system. The results obtained indicated that the PIA signal is reduced in positive samples and is increased in negative samples. Treatment with cysteine appeared to reduce nonspecific agglutination in negative samples but did not maintain the signal in positive samples.

Experiment to evaluate feasibility of utilizing Skylab-EREP remote sensing data for tectonic analysis of the Bighorn Mountains region, Wyoming-Montana

NASA Technical Reports Server (NTRS)

Hoppin, R. A. (Principal Investigator)

1974-01-01

The author has identified the following significant results. S-190A color transparencies from SL-2 of the Big Horn basin region provide the best format to date for geologic study of that region; red beds are quite mappable and resistant key beds sharply outlined. An S-190B color frame from SL-3 of the Pryor-Bighorn mountains provides no indication that the Nye-Bowler lineament extends east of East Pryor Mountain. This has important implications regarding the role of this and other lineaments (which also appear to be of restricted length) in the tectonics of the region. Extensions of these lineaments for great distances does not seem warranted on the basis of surface evidence.

The valuation of equity warrants under the fractional Vasicek process of the short-term interest rate

NASA Astrophysics Data System (ADS)

Xiao, Weilin; Zhang, Weiguo; Zhang, Xili; Chen, Xiaoyan

2014-01-01

Motivated by the empirical evidence of long range dependence in short-term interest rates and considering the long maturities of equity warrants, we propose the fractional Vasicek model to describe the dynamics of the short rate in the pricing environment of equity warrants. Using the partial differential equation approach, we present a valuation model for equity warrants under the assumption that the short rate follows the fractional Vasicek process. After identifying the pricing model for equity warrants, we provide the parameter estimation procedure for the proposed pricing model. Since obtaining the values of equity warrants from the proposed model needs to solve a nonlinear equation, we employ a hybrid intelligent algorithm to get around this optimization problem. Furthermore, to illustrate the practicality of our proposed model, we conduct an empirical study to ascertain the performance of our proposed model using the data from China’s warrant market and the China Foreign Exchange Trade System. The comparison of traditional models (such as the Black-Scholes model, the Noreen-Wolfson model, the Lauterbach-Schultz model, and the Ukhov model) with our proposed model is also presented. The empirical results show that the mean absolute percentage error of our pricing model is 10.30%. By contrast, the Black-Scholes model, the Noreen-Wolfson model, the Lauterbach-Schultz model, and the Ukhov model applied to the same warrant produce mean absolute errors of 35.26%, 37.67%, 33.40%, 32.81%, respectively. Thus the long memory property in stochastic interest rates cannot be ignored in determining the valuation of equity warrants.

Clinical and Psychosocial Profiles of Asian Immigrants Who Repeatedly Attempt Suicide: A Mixed-Method Study of Risk and Protective Factors.

PubMed

Chung, Irene W; Caine, Eric D; Barron, Charles T; Badaracco, Mary A

2015-01-01

Persons who repeatedly attempt suicide comprise a highly distressed population that warrants the understanding of risk and protective factors in assessment and treatment. There is a dearth of literature on Asian immigrants' suicidal behavior. The study aimed to capture the clinical and psychosocial profiles of Asian immigrants who made repeated suicide attempts. We utilized retrospective chart reviews (n = 44) and in-person interviews (n = 12) in two urban public hospitals. The study samples shared major suicide risk factors identified in studies of other populations. Participants of the interview sample suffered from a pervasive sense of hopelessness stemming from social isolation, self-stigma, feelings of failure in their life roles, and perceptions of rejection by their families. Conversely, psychological well-being--feeling cared for and able to reciprocate care for others--appeared to be a protective factor for participants who improved in their functioning and recovery. The study lays the groundwork for further research on suicide risk and protective factors.

Antibiotics and probiotics in treatment of inflammatory bowel disease

PubMed Central

Gionchetti, Paolo; Rizzello, Fernando; Lammers, Karen M; Morselli, Claudia; Sollazzi, Lucia; Davies, Samuel; Tambasco, Rosy; Calabrese, Carlo; Campieri, Massimo

2006-01-01

Many experimental and clinical observations suggest that intestinal microflora plays a potential role in the pathogenesis of inflammatory bowel disease (IBD). Manipulation of the luminal content using antibiotics or probiotics represents a potentially effective therapeutic option. The available studies do not support the use of antibiotics in ulcerative colitis (UC). Antibiotics are effective in treating septic complications of Crohn’s disease (CD) but their use as a primary therapy is more controversial, although this approach is frequently and successfully adopted in clinical practice. There is evidence that probiotic therapy may be effective in the prevention and treatment of mild to moderate UC. In contrast, a lack of successful study data at present precludes the widespread use of probiotics in the treatment of CD. Both antibiotics and probiotics appear to play a beneficial role in the treatment and prevention of pouchitis and further trials are warranted to fully quantify their clinical efficacy. PMID:16733845

Egg Phospholipids and Cardiovascular Health

PubMed Central

Blesso, Christopher N.

2015-01-01

Eggs are a major source of phospholipids (PL) in the Western diet. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and high-density lipoprotein (HDL) function. Based on pre-clinical studies, egg phosphatidylcholine (PC) and sphingomyelin appear to regulate cholesterol absorption and inflammation. In clinical studies, egg PL intake is associated with beneficial changes in biomarkers related to HDL reverse cholesterol transport. Recently, egg PC was shown to be a substrate for the generation of trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite associated with increased cardiovascular disease (CVD) risk. More research is warranted to examine potential serum TMAO responses with chronic egg ingestion and in different populations, such as diabetics. In this review, the recent basic science, clinical, and epidemiological findings examining egg PL intake and risk of CVD are summarized. PMID:25871489

A study of outstanding DWI warrants

DOT National Transportation Integrated Search

2001-07-01

This final report documents a project on how outstanding warrants are handled for individuals who have been charged or convicted of offenses related to driving while impaired/intoxicated (DWI), but who have absconded or defaulted in either court appe...

Cardiac mesothelial papillary hyperplasia in four dogs.

PubMed

Kirejczyk, Shannon G; Burnum, Anne L; Brown, Corrie C; Sakamoto, Kaori; Rissi, Daniel R

2018-05-01

Mesothelial papillary hyperplasia (MPH) has been described as an incidental finding on the epicardial surface of clinically normal laboratory Beagle dogs. We describe MPH in 4 dogs diagnosed with acute cardiac tamponade (1 case) or chronic cardiac disease (3 cases). Cardiac MPH appeared as distinct, soft, irregular villous plaques on the epicardial surface of the auricles and occasionally the ventricles. Histologically, areas of MPH were composed of multiple papillary fronds arising from the epicardial surface and projecting into the pericardial space. Fronds were covered by cuboidal and occasionally vacuolated mesothelial cells and were supported by loose fibrovascular stroma with various degrees of edema and inflammation. Although these may represent incidental findings with no clinical significance, the gross appearance warrants differentiation from other conditions. Additional insight into the pathogenesis of MPH is needed to fully understand its significance in the face of concurrent cardiac disease.

Thyroid malignancy among goitrous thyroid lesions: a review of hospital-based studies in Malaysia and Myanmar.

PubMed

Htwe, T T

2012-03-01

Endemic goitre is a major concern in many parts of the world, including Southeast Asia. Goitrous thyroid lesion is postulated as a precursor lesion to thyroid cancer (TC). This paper reviews the prevalence rates and characteristics of TC among cases of goitrous thyroid-swelling in different parts of Malaysia and Myanmar. Recorded data from hospital-based retrospective studies of thyroid cases, whose study periods ranged from three to 11 years, were analysed. These included research findings from the author's publications as well as other published review articles of retrospective analyses. The incidence of TC varies among gender, age, race/ethnicity and histological type. There appears to be a higher rate of occurrence among females aged 21-60 years. Papillary thyroid carcinoma is the more common histological type compared to follicular cancer. This review also presents a descriptive analysis and discussion on studies conducted in other countries. Further exploration is warranted in order to uncover the possible risk factors for the rising incidence of TC.

[Coronary artery disease--relevance of total coronary revascularization on the incidence of malignant arrhythmias].

PubMed

Brandt, A; Gulba, D C

2006-12-01

Myocardial ischemia induces redistribution of different ions (H(+), K(+), Na(+), Ca(++)) across the cardiomyocyte membrane, as well as the loss of intracellular ATP content. This results in changes in the electrical properties including shortening of the action potential, appearance of delayed afterpotentials, and a modified refractoriness of the cardiomyocyte. These changes may induce or support malignant cardiac arrhythmias. Supersensitivity of sympathetic denervated myocardium may further support the electrical instability of ischemic myocardium.Virtues of studies indicate that patients with coronary artery disease who develop complex arrhythmias during or after exercise bear a substantially increased risk for sudden cardiac death. Other studies report about arrhythmic stabilization and reduced mortality if patients with reversible myocardial ischemia receive complete revascularization. However, none of these studies is without methodological flaws. Due to the lack of methodologically sound studies in sufficiently large patient cohorts, the question whether complete coronary revascularisation improves the prognosis of patients with coronary artery disease and which strategy (medical, interventional, or surgical) warrants the best outcomes remains open.

System-Level Influences on the Sustainability of a Cognitive Therapy Program in a Community Behavioral Health Network.

PubMed

Stirman, Shannon Wiltsey; Matza, Alexis; Gamarra, Jennifer; Toder, Katherine; Xhezo, Regina; Evans, Arthur C; Hurford, Matthew; Beck, Aaron T; Crits-Christoph, Paul; Creed, Torrey

2015-07-01

The purpose of this study was to examine influences on the sustainability of a program to implement an evidence-based psychotherapy in a mental health system. Interviews with program administrators, training consultants, agency administrators, and supervisors (N=24), along with summaries of program evaluation data and program documentation, were analyzed with a directed content-analytic approach. Findings suggested a number of interconnected and interacting influences on sustainability, including alignment with emerging sociopolitical influences and system and organizational priorities; program-level adaptation and evolution; intervention flexibility; strong communication, collaboration, planning, and support; and perceived benefit. These individual factors appeared to mutually influence one another and contribute to the degree of program sustainability achieved at the system level. Although most influences were positive, financial planning and support emerged as potentially both facilitator and barrier, and evaluation of benefits at the patient level remained a challenge. Several factors appeared to contribute to the sustainability of a psychosocial intervention in a large urban mental health system and warrant further investigation. Understanding interconnections between multiple individual facilitators and barriers appears critical to advancing understanding of sustainability in dynamic systems and adds to emerging recommendations for other implementation efforts. In particular, implications of the findings include the importance of implementation strategies, such as long-term planning, coalition building, clarifying roles and expectations, planned adaptation, evaluation, diversification of financing strategies, and incentivizing implementation.

Dopamine antagonists for treatment resistance in autism spectrum disorders: review and focus on BDNF stimulators loxapine and amitriptyline.

PubMed

Hellings, Jessica A; Arnold, L Eugene; Han, Joan C

2017-04-01

Drug development and repurposing are urgently needed for individuals with autism spectrum disorders (ASD) and psychiatric comorbidity, which often presents as aggression and self-injury. Areas covered: We review dopamine antagonists, including classical and atypical, as well as unconventional antipsychotics in ASD. The older antipsychotic loxapine is discussed in terms of preliminary albeit limited evidence in ASD. Emerging promise of amitriptyline in ASD is discussed, together with promising BDNF effects of loxapine and amitriptyline. Expert opinion: In ASD, pharmacotherapy and specifically dopamine antagonist drugs are often prescribed for challenging behaviors including aggression. The novel antipsychotics risperidone and aripiprazole have received most study in ASD and are FDA-approved for irritability in children with ASD over age 5 years; individuals with ASD are prone to weight gain, Type II diabetes and associated side effects. Low dose loxapine has properties of classical and novel antipsychotics but importantly appears more weight neutral, and with promising use in adolescents and adults with ASD. Amitriptyline appears effective in ASD for irritability, aggression, gastrointestinal problems, and insomnia, in children, adolescents and adults however our adult data on amitriptyline in ASD is still in preparation for publication. Both loxapine and amitriptyline may stimulate BDNF; further studies are warranted.

[Malaria in Spain: entomological aspects and future outlook].

PubMed

Bueno Marí, Rubén; Jiménez Peydró, Ricardo

2008-01-01

Malaria was officially eradicated in Spain in 1964. However, at the present time, hundreds of imported cases are registered in our country each year. In this context, the study of the vector is seen to be highly significant in order to infer possible transmission scenarios, whether of a sporadic or a regular nature. Although the socio-economic level of the country does not appear to foreshadow the possible re-emergence of the disease in the short and medium term, the presence of well-established populations of anophelini and plasmodium gametocytes circulating in a certain percentage of the human population does appear to warrant the continuation of the current status of epidemiological surveillance. Moreover, the globalisation of markets and the emerging process of climate change could enable the colonisation of our territory by part of the Anopheles species that transmit human plasmodiosis in tropical and subtropical regions. In order to obtain a more thorough knowledge of the range of fauna, spatial distribution and bioecology of the anopheline Culicoides, a number of intensive larval samplings were taken in the Community of Valencia, a region with sufficient surface water heterogeneity and historical data of malaria prevalence to substantiate the decision to choose it for this study. Five species of the Anopheles genus, with varying degrees of impact in the dissemination of the disease, were identified.

Black-Scholes finite difference modeling in forecasting of call warrant prices in Bursa Malaysia

NASA Astrophysics Data System (ADS)

Mansor, Nur Jariah; Jaffar, Maheran Mohd

2014-07-01

Call warrant is a type of structured warrant in Bursa Malaysia. It gives the holder the right to buy the underlying share at a specified price within a limited period of time. The issuer of the structured warrants usually uses European style to exercise the call warrant on the maturity date. Warrant is very similar to an option. Usually, practitioners of the financial field use Black-Scholes model to value the option. The Black-Scholes equation is hard to solve analytically. Therefore the finite difference approach is applied to approximate the value of the call warrant prices. The central in time and central in space scheme is produced to approximate the value of the call warrant prices. It allows the warrant holder to forecast the value of the call warrant prices before the expiry date.

Added Qualifications in Microsurgery: Consideration for Subspecialty Certification in Microvascular Surgery in Europe.

PubMed

Heidekrueger, Paul I; Tanna, Neil; Weichman, Katie E; Szpalski, Caroline; Tos, Pierluigi; Ninkovic, Milomir; Broer, P Niclas

2016-07-01

Background While implementation of subspecializations may increase expertise in a certain area of treatment, there also exist downsides. Aim of this study was, across several disciplines, to find out if the technique of microsurgery warrants the introduction of a "Certificate of Added Qualifications (CAQ) in microsurgery." Methods An anonymous, web-based survey was administered to directors of microsurgical departments in Europe (n = 205). Respondents were asked, among other questions, whether they had completed a 12-month microvascular surgery fellowship and whether they believed a CAQ in microvascular surgery should be instituted. Results The response rate was 57%, and 33% of the respondents had completed a 12-month microvascular surgery fellowship.A total of 61% of all surgeons supported a CAQ in microsurgery. Answers ranged from 47% of support to 100% of support, depending on the countries surveyed. Discussion This is one of the few reports to evaluate the potential role of subspecialty certification of microvascular surgery across several European countries. The data demonstrate that the majority of directors of microsurgical departments support such a certificate. There was significantly greater support for a CAQ in microsurgery among those who have completed a formal microvascular surgery fellowship themselves. Conclusion This study supports the notion that further discussion and consideration of subspecialty certification in microvascular surgery appears necessary. There are multiple concerns surrounding this issue. Similar to the evolution of hand surgery certification, an exploratory committee of executive members of the respective medical boards and official societies may be warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Exploring the Psychological Profile of Patients with Delusional Infestation.

PubMed

Shah, Reena; Taylor, Ruth E; Bewley, Anthony

2017-01-04

Delusional infestation (DI) is an uncommon psychiatric disorder in which patients present with the false and fixed belief (i.e. a delusion) that their skin and/or their environment is infested despite objective evidence to the contrary. Within psychodermatology specialist clinics there is a high rate of DI referrals. What is not known is the level of psychiatric and psychological co-morbidities associated with DI and whether psychiatric or psychological assessment would be warranted. One-hundred and thirty-eight adult patients with DI attending an outpatient psychodermatology clinic were given 3 standardised questionnaires. The results showed that 81% had a poor quality of life; 52% with anxiety, 41.6% with depression and 49% with appearance-related concerns. This study indicates high levels of psychiatric and psychological disorders in DI which require assessment and appropriate intervention.

Hydrogeologic and geochemical characterization of groundwater resources in Deep Creek Valley and adjacent areas, Juab and Tooele Counties, Utah, and Elko and White Pine Counties, Nevada

USGS Publications Warehouse

Gardner, Philip M.; Masbruch, Melissa D.

2015-09-18

Water-level altitude contours and groundwater ages indicate the potential for a long flow path from southwest to northeast between northern Spring and Deep Creek Valleys through Tippett Valley. Although information gathered during this study is insufficient to conclude whether or not groundwater travels along this interbasin flow path, dissolved sulfate and chloride data indicate that a small fraction of the lower altitude, northern Deep Creek Valley discharge may be sourced from these areas. Despite the uncertainty due to limited data collection points, a hydraulic connection between northern Spring Valley, Tippett Valley, and Deep Creek Valley appears likely, and potential regional effects resulting from future groundwater withdrawals in northern Spring Valley warrant ongoing monitoring of groundwater levels across this area.

Stability of nonlinear waves and patterns and related topics

NASA Astrophysics Data System (ADS)

Ghazaryan, Anna; Lafortune, Stephane; Manukian, Vahagn

2018-04-01

Periodic and localized travelling waves such as wave trains, pulses, fronts and patterns of more complex structure often occur in natural and experimentally built systems. In mathematics, these objects are realized as solutions of nonlinear partial differential equations. The existence, dynamic properties and bifurcations of those solutions are of interest. In particular, their stability is important for applications, as the waves that are observable are usually stable. When the waves are unstable, further investigation is warranted of the way the instability is exhibited, i.e. the nature of the instability, and also coherent structures that appear as a result of an instability of travelling waves. A variety of analytical, numerical and hybrid techniques are used to study travelling waves and their properties. This article is part of the theme issue `Stability of nonlinear waves and patterns and related topics'.

Hypothesis: leukocyte endogenous mediator/endogenous pyrogen/lymphocyte-activating factor modulates the development of nonspecific and specific immunity and affects nutritional status.

PubMed

Powanda, M C; Beisel, W R

1982-04-01

We postulate that leukocyte endogenous mediator/endogenous pyrogen/lymphocyte-activating factor (LEM/EP/LAF) integrates the host's nonspecific and specific immune responses to infection by virtue of the panoply of physiological and metabolic activities it is capable of eliciting. The alterations in systemic metabolism modulated by LEM/EP/LAF, although apparently of value to the host in the defense against infection and the repair of tissue damage, result in negative nutrient balances. Severe infections, alone or in conjunction with injury, may result in malnutrition unless the patient is adequately nourished. Preexisting nutritional deficits can compromise host resistance to infection, in part by preventing production of LEM/EP/LAF. Additional studies of the sequelae of LEM/EP/LAF action and effects of nutrition on host resistance to infection appear warranted.

Molecular fluorescence as a monitor of minor stratospheric constituents

NASA Technical Reports Server (NTRS)

Schofield, K.

1975-01-01

The potential of molecular fluorescence was assessed as a stratospheric monitor of the concentrations of various minor species. Seventeen molecules were considered and all spectral regions from the vacuum ultraviolet through to the infrared are included. The exercise has produced few surprises; however, further confirmation has emerged as to the feasibility of this sensitive technique for monitoring stratospheric OH, NO2, and SO2, sufficient to warrant its development as analytical flight hardware for these species. All the other molecules have been eliminated with the exception of C10 which appears to have promise but requires additional information before its detection limit can be calculated; its fluorescence spectrum is as yet uninvestigated. A handbook for molecular fluorescence is presented, and a compilation of all reported studies for simple molecules using line source excitation is included.

Molecular systematics and biogeography of the amphibious genus Littorella (Plantaginaceae).

PubMed

Hoggard, Ronald K; Kores, Paul J; Molvray, Mia; Hoggard, Gloria D; Broughton, David A

2003-03-01

Littorella (Plantaginaceae) is a disjunct, amphibious genus represented by three closely related species. Littorella uniflora occurs in Europe including Iceland and the Azores, L. americana is found in temperate North America, and L. australis grows in temperate South America. Littorella has been recognized in numerous floristic treatments, but its status as a genus has recently been questioned. Rahn (Botanical Journal of the Linnean Society 120: 145-198, 1996) proposed a new phylogeny for Plantaginaceae based on morphological, embryological, and chemical data in which he reduced Littorella to a subgenus of Plantago. This article compares the phylogeny proposed by Rahn to one based on DNA sequence data from the internal transcribed spacer (ITS) region. In our analysis, Littorella forms a strongly supported monophyletic clade sister to Plantago and its recognition at the generic rank appears warranted. Littorella australis is sister to L. americana, and this clade is sister to the European L. uniflora. This more distant relationship between L. uniflora and L. americana provides support for maintaining both taxa at the specific rank and suggests a European origin for Littorella. Our studies also indicate that the monotypic genus Bougueria is deeply nested within Plantago and that its inclusion within Plantago as proposed by Rahn appears justified.

Smoking in film in New Zealand: measuring risk exposure

PubMed Central

Gale, Jesse; Fry, Bridget; Smith, Tara; Okawa, Ken; Chakrabarti, Anannya; Ah-Yen, Damien; Yi, Jesse; Townsend, Simon; Carroll, Rebecca; Stockwell, Alannah; Sievwright, Andrea; Dew, Kevin; Thomson, George

2006-01-01

Background Smoking in film is a risk factor for smoking uptake in adolescence. This study aimed to quantify exposure to smoking in film received by New Zealand audiences, and evaluate potential interventions to reduce the quantity and impact of this exposure. Methods The ten highest-grossing films in New Zealand for 2003 were each analysed independently by two viewers for smoking, smoking references and related imagery. Potential interventions were explored by reviewing relevant New Zealand legislation, and scientific literature. Results Seven of the ten films contained at least one tobacco reference, similar to larger film samples. The majority of the 38 tobacco references involved characters smoking, most of whom were male. Smoking was associated with positive character traits, notably rebellion (which may appeal to adolescents). There appeared to be a low threshold for including smoking in film. Legislative or censorship approaches to smoking in film are currently unlikely to succeed. Anti-smoking advertising before films has promise, but experimental research is required to demonstrate cost effectiveness. Conclusion Smoking in film warrants concern from public health advocates. In New Zealand, pre-film anti-smoking advertising appears to be the most promising immediate policy response. PMID:17020623

An investigation into semantic and phonological processing in individuals with Williams syndrome.

PubMed

Lee, Cheryl S; Binder, Katherine S

2014-02-01

The current study examined semantic and phonological processing in individuals with Williams syndrome (WS). Previous research in language processing in individuals with WS suggests a complex linguistic system characterized by "deviant" semantic organization and differential phonological processing. Two experiments explored these representations in individuals with WS. The first experiment analyzed the relative typicality and frequency of participants' responses to a semantic and phonological fluency task. The second experiment tapped into online language processing through a semantic priming task and an online sentence reading task measuring the effects of word frequency. Thirteen participants with WS were matched to a group of participants on reading grade level and a group of participants on chronological age. The results of the semantic fluency task, semantic priming task, and word frequency task suggest that semantic organization in individuals with WS appears commensurate with their reading level rather than deviant. The pattern of results suggests that individuals with WS do not appear to have deviant semantic organization, while confirming that online tasks that tap into these processes are a promising direction in investigations that include atypically developing populations. These findings for the phonological tasks warrant further research into phonological processing in individuals with WS.

Differential relationships between language skills and working memory in Turkish-Dutch and native-Dutch first-graders from low-income families.

PubMed

Bosman, Anna M T; Janssen, Marije

2017-01-01

In the Netherlands, Turkish-Dutch children constitute a substantial group of children who learn to speak Dutch at the age of four after they learned to speak Turkish. These children are generally academically less successful. Academic success appears to be affected by both language proficiency and working memory skill. The goal of this study was to investigate the relationship between language skills and working memory in Turkish-Dutch and native-Dutch children from low-income families. The findings revealed reduced Dutch language and Dutch working-memory skills for Turkish-Dutch children compared to native-Dutch children. Working memory in native-Dutch children was unrelated to their language skills, whereas in Turkish-Dutch children strong correlations were found both between Turkish language skills and Turkish working-memory performance and between Dutch language skills and Dutch working-memory performance. Reduced language proficiencies and reduced working-memory skills appear to manifest itself in strong relationships between working memory and language skills in Turkish-Dutch children. The findings seem to indicate that limited verbal working-memory and language deficiencies in bilingual children may have reciprocal effects that strongly warrants adequate language education.

BounceBack capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study.

PubMed

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-06-05

Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack, to alleviate the severity of DOMS after standardized eccentric exercise. The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18-45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. In this controlled pilot study, intake of BounceBack capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). BounceBack capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results.

BounceBack™ capsules for reduction of DOMS after eccentric exercise: a randomized, double-blind, placebo-controlled, crossover pilot study

PubMed Central

Udani, Jay K; Singh, Betsy B; Singh, Vijay J; Sandoval, Elizabeth

2009-01-01

Background Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack™, to alleviate the severity of DOMS after standardized eccentric exercise. Methods The study was a randomized, double-blind, placebo-controlled, crossover study. Ten healthy community-dwelling untrained subjects, ranging in age from 18–45 years, were enrolled. Mean differences within and between groups were assessed inferentially at each data collection time-point using t-tests for all outcome measures. Results In this controlled pilot study, intake of BounceBack™ capsules for 30 days resulted in a significant reduction in standardized measures of pain and tenderness post-eccentric exercise compared to the placebo group. There were trends towards reductions in plasma indicators of inflammation (high sensitivity C-reactive protein) and muscle damage (creatine phosphokinase and myoglobin). Conclusion BounceBack™ capsules were able to significantly reduce standardized measures of pain and tenderness at several post-eccentric exercise time points in comparison to placebo. The differences in the serological markers of DOMS, while not statistically significant, appear to support the clinical findings. The product appears to have a good safety profile and further study with a larger sample size is warranted based on the current results. PMID:19500355

A phase II study of bortezomib in patients with MALT lymphoma

PubMed Central

Troch, Marlene; Jonak, Constanze; Müllauer, Leonhard; Püspök, Andreas; Formanek, Michael; Hauff, Wolfgang; Zielinski, Christoph C.; Chott, Andreas; Raderer, Markus

2009-01-01

We have performed a phase II study to evaluate bortezomib in patients with MALT-lymphoma. Sixteen patients entered the trial, 4 had gastric MALT-lymphoma, 7 of the ocular adnexa, one of the colon, and 2 of the parotid, and one patient each the lung and the breast. Bortezomib was given at 1.5 mg/m2 days 1, 4, 8 and 11; repeated every 21 days. The overall response rate was 80% (13/16); 7 patients achieved complete remission (43%), 6 partial response (37%) and 3 stable disease. After a median follow-up of 23 months (range; 8–26), all patients are alive and 4 have relapsed. Fifteen patients required dose reductions due to either neuropathy (7 patients) or diarrhea (8 patients). Bortezomib appears to be active in patients with MALT-lymphoma. However, an unexpectedly high rate of toxicities was seen, warranting assessment of combination schedules with bortezomib at a lower dose than given in our study (ClinicalTrials.govIdentifier: NCT 00373906). PMID:19336742

Cold Exposure Exacerbates the Development of Diabetic Polyneuropathy in the Rat

PubMed Central

Kasselman, Lora J.; Veves, Aristidis; Gibbons, Christopher H.; Rutkove, Seward B.

2009-01-01

Diabetic polyneuropathy (DPN) and cold-induced nerve injury share several pathogenic mechanisms. This study explores whether cold exposure contributes to the development of DPN. Streptozotocin-induced diabetic rats and controls were exposed to a room temperature (23°C) or cold environment (10°C). H-reflex, tail and sciatic motor, and sensory nerve conduction studies were performed. Analyses of sural nerve, intraepidermal nerve fibers, and skin and nerve nitrotyrosine ELISAs were performed. Diabetic animals exposed to a cold environment had an increased H-reflex four weeks earlier than diabetic room temperature animals (P = .03). Cold-exposed diabetic animals also had greater reduction in motor conduction velocities at 20 weeks (P = .017), decreased skin nerve fiber density (P = .037), and increased skin nitrotyrosine levels (P = .047). Cold exposure appears to hasten the development of DPN in the rat STZ model of diabetes. These findings support that further study into the relationship between ambient temperature and DPN is warranted. PMID:20130819

A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders.

PubMed

Barlow, J H; Ellard, D R; Hainsworth, J M; Jones, F R; Fisher, A

2005-04-01

To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD). Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed. Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness. Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders. Copyright 2005 Blackwell Munksgaard.

A rare eicosanoid precursor analogue, sciadonic acid (5Z,11Z,14Z-20:3), detected in vivo in hormone positive breast cancer tissue.

PubMed

Park, H G; Zhang, J Y; Foster, C; Sudilovsky, D; Schwed, D A; Mecenas, J; Devapatla, S; Lawrence, P; Kothapalli, K S D; Brenna, J T

2018-07-01

Numerous genetic alterations of HSA 11q13 are found frequently in several cancer types, including breast cancer (BC). The 11q13 locus harbors FADS2 encoding Δ6 desaturation which is not functional in several cancer cell lines, including hormone positive MCF7 BC cells. In vitro, the non-functional FADS2 activity unmasks 18:2n-6 elongation to 20:2n-6 and Δ5 desaturation by FADS1 to yield 5Z,11Z,14Z-20:3 (sciadonic acid) rather than 5Z,8Z,11Z,14Z-20:4 (arachidonic acid). In this pilot study we aimed to determine whether 5,11,14-20:3 appears in vivo in hormone positive human BC tissue. Fatty acids were profiled in surgically removed human breast tumor and adjacent normal tissue (n = 9). Sciadonic acid was detected in three of nine breast tumor samples and was below detect limits in normal breast tissue. The internal Δ8 double bond of arachidonic acid is required for normal eicosanoid synthesis but is missing in sciadonic acid. This pilot study demonstrates for the first time in vivo sciadonic acid in hormone positive BC tissue, warranting a larger survey study to further evaluate its appearance and the functional implications. Copyright © 2018. Published by Elsevier Ltd.

Updated Review of the Applied Physiology of American College Football: Physical Demands, Strength and Conditioning, Nutrition, and Injury Characteristics of America's Favorite Game.

PubMed

Fullagar, Hugh H K; McCunn, Robert; Murray, Andrew

2017-11-01

While there are various avenues for performance improvement in college American football (AF), there is no comprehensive evaluation of the collective array of resources around performance, physical conditioning, and injury and training/game characteristics to guide future research and inform practitioners. Accordingly, the aim of the present review was to provide a current examination of these areas in college AF. Recent studies show that there is a wide range of body compositions and strength characteristics between players, which appear to be influenced by playing position, level of play, training history/programming, and time of season. Collectively, game demands may require a combination of upper- and lower-body strength and power production, rapid acceleration (positive and negative), change of direction, high running speed, high-intensity and repetitive collisions, and muscle-strength endurance. These may be affected by the timing of and between-plays and/or coaching style. AF players appear to possess limited nutrition and hydration practices, which may be disadvantageous to performance. AF injuries appear due to a multitude of factors-strength, movement quality, and previous injury-while there is also potential for extrinsic factors such as playing surface type, travel, time of season, playing position, and training load. Future proof-of-concept studies are required to determine the quantification of game demands with regard to game style, type of opposition, and key performance indicators. Moreover, more research is required to understand the efficacy of recovery and nutrition interventions. Finally, the assessment of the relationship between external/internal-load constructs and injury risk is warranted.

Relaxin family peptides in the male reproductive system--a critical appraisal.

PubMed

Ivell, Richard; Kotula-Balak, Malgorzata; Glynn, Danielle; Heng, Kee; Anand-Ivell, Ravinder

2011-02-01

The human genome project has identified, besides ovarian relaxin (RLN), six other relaxin-like molecules (RLN3, H1-RLN, INSL3-6), most of which appear to be expressed in the testis and/or male reproductive system, together with four different G-protein-coupled receptors responsive to one or other of these peptides. Earlier work on relaxin in the male assumed the simplistic hypothesis of only a single relaxin-like entity. This review systematically examines the expression and physiology of relaxin-like molecules in the male reproductive system in order to reappraise the importance of this hormone system for male reproductive function. Although there are important species differences, only INSL3 and INSL6 appear to be generally expressed at a moderately high level within the testis, whereas ovarian RLN is consistently a major secretory product of the prostate epithelium. However, all members of this relaxin-like family appear to be expressed also at a low level in different organs of the male reproductive system, suggesting possible autocrine/paracrine effects. The four receptors (RXFP1-4) for these peptides are also expressed to differing levels in both somatic and seminiferous compartments of the testis and in the prostate, supporting relevant functions for most members of this interesting peptide family. Recent studies of relaxin family peptides in prostate pathology highlight their functional importance in the clinical context as potential causative, diagnostic and therapeutic agents and warrant more specific and detailed studies of their roles also in regard to male fertility and other aspects of male reproductive function.

Low statistical power in biomedical science: a review of three human research domains.

PubMed

Dumas-Mallet, Estelle; Button, Katherine S; Boraud, Thomas; Gonon, Francois; Munafò, Marcus R

2017-02-01

Studies with low statistical power increase the likelihood that a statistically significant finding represents a false positive result. We conducted a review of meta-analyses of studies investigating the association of biological, environmental or cognitive parameters with neurological, psychiatric and somatic diseases, excluding treatment studies, in order to estimate the average statistical power across these domains. Taking the effect size indicated by a meta-analysis as the best estimate of the likely true effect size, and assuming a threshold for declaring statistical significance of 5%, we found that approximately 50% of studies have statistical power in the 0-10% or 11-20% range, well below the minimum of 80% that is often considered conventional. Studies with low statistical power appear to be common in the biomedical sciences, at least in the specific subject areas captured by our search strategy. However, we also observe evidence that this depends in part on research methodology, with candidate gene studies showing very low average power and studies using cognitive/behavioural measures showing high average power. This warrants further investigation.

Low statistical power in biomedical science: a review of three human research domains

PubMed Central

Dumas-Mallet, Estelle; Button, Katherine S.; Boraud, Thomas; Gonon, Francois

2017-01-01

Studies with low statistical power increase the likelihood that a statistically significant finding represents a false positive result. We conducted a review of meta-analyses of studies investigating the association of biological, environmental or cognitive parameters with neurological, psychiatric and somatic diseases, excluding treatment studies, in order to estimate the average statistical power across these domains. Taking the effect size indicated by a meta-analysis as the best estimate of the likely true effect size, and assuming a threshold for declaring statistical significance of 5%, we found that approximately 50% of studies have statistical power in the 0–10% or 11–20% range, well below the minimum of 80% that is often considered conventional. Studies with low statistical power appear to be common in the biomedical sciences, at least in the specific subject areas captured by our search strategy. However, we also observe evidence that this depends in part on research methodology, with candidate gene studies showing very low average power and studies using cognitive/behavioural measures showing high average power. This warrants further investigation. PMID:28386409

Nosocomial Varicella

PubMed Central

Meyers, Joel D.; MacQuarrie, Michael B.; Merigan, Thomas C.; Jennison, M. Harry

1979-01-01

Twenty cases of varicella occurred in patients or siblings of patients in a 41-day period in a children's hospital. Most cases were among oncology patients, with transmission occurring in both the inpatient and outpatient areas. One patient died after visceral dissemination of varicella. Neither pooled immunoglobulin nor zoster immune plasma was effective in preventing clinical varicella, although zoster immune plasma appeared to ameliorate the illness. Recommended control measures included strict isolation or discharge of infected patients, and respiratory isolation or discharge of exposed susceptibles. Although apparently too late to be effective in this outbreak, similar measures are warranted should nosocomial outbreaks of varicella occur elsewhere. PMID:425501

Evaluation of Novel Wet Chemistry Separation and Purification Methods to Facilitate Automation of Astatine-­211 Isolation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilbur, Daniel Scott

This research is a collaborative effort between the research groups of the PIs, Dr. D. Scott Wilbur in the Department of Radiation Oncology at the University of Washington (UW) and Matthew O’Hara at the Pacific Northwest National Laboratory (PNNL). In this report only those studies conducted at UW and the budget information from UW will be reported. A separate progress and financial report will be provided by PNNL. This final report outlines the experiments (Tasks) conducted and results obtained at UW from July 1, 2013 thru June 30, 2016 (2-­year project with 1 year no-­cost extension). The report divides themore » information on the experiments and results obtained into the 5 specific objectives of the research efforts and the Tasks within those objectives. This format is used so that it is easy to see what has been accomplished in each area. A brief summary of the major findings from the studies is provided below. Summary of Major Findings from Research/Training Activities at UW: Anion and cation exchange columns did not provide adequate 211At capture and/or extraction results under conditions studied to warrant further evaluation; PEG-­Merrifield resins containing mPEG350, mPEG750, mPEG2000 and mPEG5000 were synthesized and evaluated; All of the mPEG resins with different sized mPEG moieties conjugated gave similar 211At capture (>95%) from 8M HCl solutions and release with conc. NH 4OH (~50-­80%), but very low quantities were released when NaOH was used as an eluent; Capture and release of 211At when loading [ 211At]astatate appeared to be similar to that of [ 211At]astatide on PEG columns, but further studies need to be conducted to confirm that; Capture of 211At on PEG columns was lower (e.g. 80-­90%) from solutions of 8M HNO 3, but higher capture rates (e.g. 99%) can be obtained when 10M HNO 3 is mixed with an equal quantity of 8M HCl; Addition of reductants to the 211At solutions did not appear to change the percent capture, but may have an effect on the % extracted; There was some indication that the PEG-­Merrifield resins could be saturated (perhaps with Bi) resulting in lower capture percentages, but more studies need to be done to confirm that; A target dissolution chamber, designed and built at PNNL, works well with syringe pumps so it can be used in an automated system; Preliminary semi-­automated 211At isolation studies have been conducted with full-scale target dissolution and 211At isolation using a PEG column on the Hamilton automated system gave low overall recoveries, but HNO 3 was used (rather than HCl) for loading the 211At and flow rates were not optimized; Results obtained using PEG columns are high enough to warrant further development on a fully automated system; Results obtained also indicate that additional studies are warranted to evaluate other types of columns for 211At separation from bismuth, which allow use of HNO 3/HCl mixtures for loading and NaOH for eluting 211At. Such a column could greatly simplify the overall isolation process and make it easier to automate.« less

Emotional and Disciplinary Responses of Preservice Teachers to Young Children's Misbehavior.

ERIC Educational Resources Information Center

Reschke, Kathy L.; Hegland, Susan M.

This study assessed 133 preservice teachers' emotional and disciplinary responses to kindergarten children's misbehavior. Subjects were presented with hypothetical scenarios of two types: those warranting direct adult management and those warranting indirect adult management. Subjects rated levels of their own negative affect and the perceived…

Clinical characteristics of children with fever and transient neutropenia who experience serious bacterial infections.

PubMed

Bonadio, W A; Stremski, E; Shallow, K

1989-09-01

A review of consecutive previously healthy children with fever and newly discovered neutropenia without underlying malignancy, evaluated during a three-year period, was performed. A total of 68 episodes occurred in 68 patients; blood culture was performed on each. Of 17 patients who appeared compromised (ill, irritable, toxic) on presentation, five (30%) had either bacteremia or bacterial meningitis. All five patients had clinical evidence of a fulminant disease process on examination. By contrast, all 51 patients who appeared to be well on presentation were culture-negative. Fever and new-onset neutropenia in children is a heterogeneous disorder with several outcomes. Any child with fever and newly discovered neutropenia who appears ill should be presumed to be at high risk for systemic bacterial infection and receive hospitalization for parenteral antibiotic therapy. By contrast, the previously healthy child older than two months of age with fever and new-onset neutropenia who appears to be well, and whose clinical evaluation does not indicate a serious underlying disease process, is at low risk for accompanying systemic bacterial infection; hospitalization with empiric antibiotic therapy pending culture results is not warranted for the majority of such children. Close outpatient monitoring with serial evaluation of the peripheral blood absolute neutrophil count to document bone marrow recovery is recommended for such cases.

Suppressive effect of delta 9-tetrahydrocannabinol in vitro on phagocytosis by murine macrophages.

PubMed

Friedman, M; Cepero, M L; Klein, T; Friedman, H

1986-06-01

Incubation of normal mouse peritoneal cells consisting of over 90% phagocytizing macrophages with delta 9-tetrahydrocannabinol (THC) resulted in a inhibition of phagocytic function. The THC in a dose-related manner suppressed the percentage of macrophages per culture which ingested yeast and the average number of yeast particles ingested by the phagocytizing macrophages. The vehicle used to suspend the THC in vitro, i.e., DMSO, had no detectable effect on macrophage function. Suppression of phagocytosis with no effects on viability or cell number occurred with doses of 10 micrograms or less THC per milliliter culture medium. Measurable suppression also occurred after 24- to 48-hr treatment of the macrophages with the THC. This compound had little if any detectable effect on phagocytosis when added directly to the cultures shortly before testing for phagocytosis. Further studies concerning the effects of THC on macrophage function appear warranted.

Removal of dissolved textile dyes from wastewater by a compost sorbent

USGS Publications Warehouse

Tsui, L.S.; Roy, W.R.; Cole, M.A.

2003-01-01

The objective of this study was to evaluate the potential for treating dye-contaminated waste streams by sorption using compost as a low-cost sorbent. A mature, thermophilic compost sample was used to sorb CI Acid Black 24, CI Acid Orange 74, CI Basic Blue 9, CI Basic Green 4, CI Direct Blue 71, CI Direct Orange 39, CI Reactive Orange 16 and CI Reactive Red 2 from solution using a batch-sorption method. With the exception of the two reactive dyes, the sorption kinetics were favourable for a continuous-flow treatment process with the compost-dye mixtures reaching a steady state within 3-5 h. Based on limited comparisons, the affinity of the compost for each dye appeared to be competitive with other non-activated carbon sorbents. The results suggest that additional research on using compost as a sorbent for dye-contaminated solutions is warranted.

Towards a 21st century roadmap for biomedical research and ...

EPA Pesticide Factsheets

Decades of costly failures in translating drug candidates from preclinical disease models to human therapeutic use warrant reconsideration of the priority placed on animal models in biomedical research. Following an international workshop attended by experts from academia, government institutions, research funding bodies and the corporate and NGO sectors, this consensus report analyses, as case studies, five disease areas with major unmet needs for new treatments. In view of the scientifically driven transition towards a human pathways-based paradigm in toxicology, a similar paradigm shift appears to be justified in biomedical research. There is a pressing need for an approach that strategically implements advanced, human biology-based models and tools to understand disease pathways at multiple biological scales. We present recommendations to help achieve this. To discover and develop new therapies, we need 21-century roadmaps for biomedical research based on multiscale human disease pathways, and supported by policy and funding strategies that prioritise human relevance.

Towards a 21st-century roadmap for biomedical research and drug discovery: consensus report and recommendations.

PubMed

Langley, Gillian R; Adcock, Ian M; Busquet, François; Crofton, Kevin M; Csernok, Elena; Giese, Christoph; Heinonen, Tuula; Herrmann, Kathrin; Hofmann-Apitius, Martin; Landesmann, Brigitte; Marshall, Lindsay J; McIvor, Emily; Muotri, Alysson R; Noor, Fozia; Schutte, Katrin; Seidle, Troy; van de Stolpe, Anja; Van Esch, Hilde; Willett, Catherine; Woszczek, Grzegorz

2017-02-01

Decades of costly failures in translating drug candidates from preclinical disease models to human therapeutic use warrant reconsideration of the priority placed on animal models in biomedical research. Following an international workshop attended by experts from academia, government institutions, research funding bodies, and the corporate and non-governmental organisation (NGO) sectors, in this consensus report, we analyse, as case studies, five disease areas with major unmet needs for new treatments. In view of the scientifically driven transition towards a human pathways-based paradigm in toxicology, a similar paradigm shift appears to be justified in biomedical research. There is a pressing need for an approach that strategically implements advanced, human biology-based models and tools to understand disease pathways at multiple biological scales. We present recommendations to help achieve this. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coagulation Abnormalities of Sickle Cell Disease: Relationship with Clinical Outcomes and the Effect of Disease Modifying Therapies

PubMed Central

Noubouossie, Denis; Key, Nigel S.; Ataga, Kenneth I.

2015-01-01

Sickle cell disease (SCD) is a hypercoagulable state. Patients exhibit increased platelet activation, high plasma levels of markers of thrombin generation, depletion of natural anticoagulant proteins, abnormal activation of the fibrinolytic system, and increased tissue factor expression, even in the non-crisis “steady state.” Furthermore, SCD is characterized by an increased risk of thrombotic complications. The pathogenesis of coagulation activation in SCD appears to be multi-factorial, with contributions from ischemia-reperfusion injury and inflammation, hemolysis and nitric oxide deficiency, and increased sickle RBC phosphatidylserine expression. Recent studies in animal models suggest that activation of coagulation may contribute to the pathogenesis of SCD, but the data on the contribution of coagulation and platelet activation to SCD-related complications in humans are limited. Clinical trials of new generations of anticoagulants and antiplatelet agents, using a variety of clinical endpoints are warranted. PMID:26776344

Comparative ultrastructure of the cuticle of trichostrongyle nematodes.

PubMed

Beveridge, I; Durette-Desset, M C

1994-09-01

The ultrastructure of the cuticle was examined in Austrostrongylus victoriensis, Patricialina birdi and Woolleya monodelphis (Herpetostrongylidae) from marsupials, Paraustrostrongylus ratti (Herpetostrongylidae) from rodents, Nippostrongylus magnus and Odilia bainae (Heligmonellidae) from rodents, Cooperia oncophora and Camelostrongylus mentulatus (Trichostrongylidae) from ruminants, and Nematodirus spathiger (Molineidae) from ruminants. The principal cuticular layers described previously were present in all species investigated. Major differences in the shape and composition of cuticular struts were observed as well as differences in components of the median zone of the cuticle, including the fluid-filled regions present in several species. Several different types of strut were observed. Although strut structure within the Heligmonellidae appeared to be constant, there were variations within both the Herpetostrongylidae and Trichostrongylidae. In Nem. spathiger the cuticular ridges lacked struts. The diversity of structures found in the species examined suggests that more extensive comparative studies of the trichostrongyle cuticle are warranted.

Efficacy and cost of micronutrient treatment of childhood psychosis

PubMed Central

Rodway, Megan; Vance, Annette; Watters, Amany; Lee, Helen; Bos, Elske; Kaplan, Bonnie J

2012-01-01

Psychosis is difficult to treat effectively with conventional pharmaceuticals, many of which have adverse long-term health consequences. In contrast, there are promising reports from several research groups of micronutrient treatment (vitamins, minerals, amino acids and essential fatty acids) of mood, anxiety and psychosis symptoms using a complex formula that appears to be safe and tolerable. We review previous studies using this formula to treat mental symptoms, and present an 11-year-old boy with a 3-year history of mental illness whose parents chose to transition him from medication to micronutrients. Symptom severity was monitored in three clusters: anxiety, obsessive compulsive disorder and psychosis. Complete remission of psychosis occurred, and severity of anxiety and obsessional symptoms decreased significantly (p<0.001); the improvements are sustained at 4-year follow-up. A cost comparison revealed that micronutrient treatment was <1% of his inpatient mental healthcare. Additional research on broad-spectrum micronutrient treatment is warranted. PMID:23144350

Fail-safe system for activity cooled supersonic and hypersonic aircraft. [using liquid hydrogen fuel

NASA Technical Reports Server (NTRS)

Jones, R. A.; Braswell, D. O.; Richie, C. B.

1975-01-01

A fail-safe-system concept was studied as an alternative to a redundant active cooling system for supersonic and hypersonic aircraft which use the heat sink of liquid-hydrogen fuel for cooling the aircraft structure. This concept consists of an abort maneuver by the aircraft and a passive thermal protection system (TPS) for the aircraft skin. The abort manuever provides a low-heat-load descent from normal cruise speed to a lower speed at which cooling is unnecessary, and the passive TPS allows the aircraft skin to absorb the abort heat load without exceeding critical skin temperature. On the basis of results obtained, it appears that this fail-safe-system concept warrants further consideration, inasmuch as a fail-safe system could possibly replace a redundant active cooling system with no increase in weight and would offer other potential advantages.

Superficial Femoral Artery Intervention by Single Transpedal Arterial Access.

PubMed

Amoroso, Nicholas S; Shah, Sooraj; Liou, Michael; Ratcliffe, Justin; Lala, Moinakhtar; Diwan, Ravi; Huang, Yili; Rosero, Hugo; Coppola, John; Bertrand, Olivier F; Kwan, Tak W

2015-11-01

Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting. In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation). All patients underwent successful SFA stenting without complication. Procedure time varied from 51 to 72 minutes. The mean contrast amount used was 56 mL; mean fluoroscopy time was 21 minutes; mean radiation dose was 91 mGy. At 1-month follow-up, duplex ultrasonography showed that all pedal arteries had remained patent. Transpedal artery approach as a primary approach to SFA stenting appears feasible and safe. Comparative trials with standard percutaneous femoral approach are warranted.

Fixing our focus: Training attention to regulate emotion

PubMed Central

Wadlinger, Heather A.; Isaacowitz, Derek M.

2010-01-01

Empirical studies have frequently linked negative attentional biases with attentional dysfunction and negative moods; however, far less research has focused on how attentional deployment can be an adaptive strategy that regulates emotional experience. We argue that attention may be an invaluable tool for promoting emotion regulation. Accordingly, we present evidence that selective attention to positive information reflects emotion regulation, and that regulating attention is a critical component of the emotion regulatory process. Furthermore, attentional regulation can be successfully trained through repeated practice. We ultimately propose a model of attention training methodologies integrating attention-dependent emotion regulation strategies with attention networks. While additional interdisciplinary research is needed to bolster these nascent findings, meditative practices appear to be among the most effective training methodologies in enhancing emotional well-being. Further exploration of the positive and therapeutic qualities of attention warrants the empirical attention of social and personality psychologists. PMID:20435804

Parental Substance Use Impairment, Parenting and Substance Use Disorder Risk

PubMed Central

Arria, Amelia M.; Mericle, Amy A.; Meyers, Kathleen; Winters, Ken C.

2011-01-01

Using data from a nationally representative sample, this study investigated substance use disorder (SUD) among respondents ages 15-54 as a function of their parents’ substance-related impairment and parents’ treatment history. Additionally, associations among maternal and paternal substance-related impairment, specific parenting behaviors, and the risk for SUD in the proband were examined. As expected, parental substance-related impairment was associated with SUD. Paternal treatment history was associated with a decreased risk for SUD in the proband, but did not appear to be associated with positive parenting practices. Results of post-hoc analyses suggested that parenting behaviors might operate differently to influence SUD risk in children where parents are affected by substance use problems compared to non-affected families. Future research is warranted to better understand the complex relationships among parental substance use, treatment, parenting behaviors, and SUD risk in offspring. Opportunities might exist within treatment settings to improve parenting skills. PMID:22112506

LANDSAT applications to wetlands classification in the upper Mississippi River Valley. Ph.D. Thesis. Final Report

NASA Technical Reports Server (NTRS)

Lillesand, T. M.; Werth, L. F. (Principal Investigator)

1980-01-01

A 25% improvement in average classification accuracy was realized by processing double-date vs. single-date data. Under the spectrally and spatially complex site conditions characterizing the geographical area used, further improvement in wetland classification accuracy is apparently precluded by the spectral and spatial resolution restrictions of the LANDSAT MSS. Full scene analysis of scanning densitometer data extracted from scale infrared photography failed to permit discrimination of many wetland and nonwetland cover types. When classification of photographic data was limited to wetland areas only, much more detailed and accurate classification could be made. The integration of conventional image interpretation (to simply delineate wetland boundaries) and machine assisted classification (to discriminate among cover types present within the wetland areas) appears to warrant further research to study the feasibility and cost of extending this methodology over a large area using LANDSAT and/or small scale photography.

An evaluation of MES (2(N-Morpholino)ethanesulfonic acid) and Amberlite IRC-50 as pH buffers for nutrient solution studies

NASA Technical Reports Server (NTRS)

Bugbee, B. G.; Salisbury, F. B.

1985-01-01

All buffering agents used to stabilize pH in hydroponic research have disadvantages. Inorganic buffers are absorbed and may become phytotoxic. Solid carbonate salts temporarily mitigate decreasing pH but provide almost no protection against increasing pH, and they alter nutrient absorption. Exchange resins are more effective, but we find that they remove magnesium and manganese from solution. We have tested 2(N-Morpholino)ethanesulfonic acid (MES) as a buffering agent at concentrations of 1 and 10 mol m-3 (1 and 10 mM) with beans, corn, lettuce, tomatoes, and wheat. MES appears to be biologically inert and does not interact significantly with other solution ions. Relative growth rates among controls and MES treatments were nearly identical for each species during the trial period. The pH was stabilized by 1 mol m-3 MES. This buffer warrants further consideration in nutrient research.

It's a sentence, not a word: insights from a keyword analysis in cancer communication.

PubMed

Taylor, Kimberly; Thorne, Sally; Oliffe, John L

2015-01-01

Keyword analysis has been championed as a methodological option for expanding the insights that can be extracted from qualitative datasets using various properties available in qualitative software. Intrigued by the pioneering applications of Clive Seale and his colleagues in this regard, we conducted keyword analyses for word frequency and "keyness" on a qualitative database of interview transcripts from a study on cancer communication. We then subjected the results from these operations to an in-depth contextual inquiry by resituating word instances within their original speech contexts, finding that most of what had initially appeared as group variations broke down under close analysis. In this article, we illustrate the various threads of analysis, and explain how they unraveled under closer scrutiny. On the basis of this tentative exercise, we conclude that a healthy skepticism for the benefits of keyword analysis within a qualitative investigative process seems warranted. © The Author(s) 2014.

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders

PubMed Central

Espel, Hallie M.; Goldstein, Stephanie P.; Manasse, Stephanie M.; Juarascio, Adrienne S.

2016-01-01

Purpose This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Methods Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Results Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Conclusions Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted. PMID:26511501

Chocolate: food for moods.

PubMed

Wong, S Y; Lua, P L

2011-08-01

Chocolate is a popular food and its consumption has long been associated with enjoyment and pleasure. The effect of chocolate on mood too has long been recognised. Chocolate is thought to have interactions with neurotransmitters which contribute to mood modulation and appetite regulation. However, the evidence in chocolate and mood studies remains highly controversial. As more is known about the influence of chocolate on mood, the reasons for these effects appear increasingly complex and inter-related. We reviewed chocolate's properties and the principal hypotheses addressing its mood altering propensities. The relationship between chocolate and mood are highly complex, combining psychopharmacological components, nutritional and sensory characteristics of the food. Individual and situational differences on chocolate consumption may also exert influence on mood and the mixed results in previous research indicate that the direction of the association remains unclear. The association between chocolate consumption and emotions warrants further multi-prong investigations to substantiate chocolate's mood alterating propensity.

Stability of nonlinear waves and patterns and related topics.

PubMed

Ghazaryan, Anna; Lafortune, Stephane; Manukian, Vahagn

2018-04-13

Periodic and localized travelling waves such as wave trains, pulses, fronts and patterns of more complex structure often occur in natural and experimentally built systems. In mathematics, these objects are realized as solutions of nonlinear partial differential equations. The existence, dynamic properties and bifurcations of those solutions are of interest. In particular, their stability is important for applications, as the waves that are observable are usually stable. When the waves are unstable, further investigation is warranted of the way the instability is exhibited, i.e. the nature of the instability, and also coherent structures that appear as a result of an instability of travelling waves. A variety of analytical, numerical and hybrid techniques are used to study travelling waves and their properties.This article is part of the theme issue 'Stability of nonlinear waves and patterns and related topics'. © 2018 The Author(s).

Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

PubMed

Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

2016-06-01

This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

What does viewing a pro-anorexia website do? An experimental examination of website exposure and moderating effects.

PubMed

Bardone-Cone, Anna M; Cass, Kamila M

2007-09-01

This study experimentally examined the effects of viewing a pro-anorexia website. Following construction of a prototypic pro-anorexia website, 235 female undergraduates were randomly assigned to view either the pro-anorexia website or one of two comparison websites related to female fashion (using average-sized models) or home décor. Post-website affect, cognitions, and behavioral expectations were examined along with moderator effects. Study participants exposed to the pro-anorexia website had greater negative affect, lower social self-esteem, and lower appearance self-efficacy post-website than those who viewed a comparison website. Additionally, they perceived themselves as heavier, reported a greater likelihood of exercising and thinking about their weight in the near future, and engaged in more image comparison. Minimal support was found for moderator effects. Results provide an empirical basis for concern (expressed by clinicians, researchers, the media) that pro-anorexia websites are a troubling new form of thin-ideal exposure that warrants further examination. (c) 2007 by Wiley Periodicals, Inc.

Supporting Families to Cook at Home and Eat Together: Findings From a Feasibility Study.

PubMed

Utter, Jennifer; Denny, Simon

The current study tested the feasibility and acceptability of an intervention that provided families with meal plans, recipes, and ingredients to cook meals at home. Ten diverse families (1 adolescent, 1 parent) were provided with the resources to prepare 5 family dinners/wk for 8 weeks. Process data were collected by weekly telephone calls. Outcome data were collected by open-ended interviews with parent or caregiver and adolescents, separately. Most of the meals provided were prepared (86%) and a high proportion of meals prepared were eaten together by families (96%). Both parents and adolescents reported that the intervention was acceptable, particularly the opportunity to try new foods. Families reported multiple benefits to participation, including eating healthier, feeling better, and having improved relationships. Providing families with resources for home cooking appears to be an acceptable and well-enjoyed intervention. Further research measuring the health and social impacts of this intervention is warranted. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Defining and Negotiating the Social Value of Research in Public Health Facilities: Perceptions of Stakeholders in a Research-Active Province of South Africa.

PubMed

Lutge, Elizabeth; Slack, Catherine; Wassenaar, Douglas

2017-02-01

This article reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasize the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasize its contribution to the healthcare system and to current patients. Furthermore, relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximize value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention. © 2017 John Wiley & Sons Ltd.

Treatment of focal articular cartilage lesions of the knee with autogenous osteochondral graftsA 2- to 4-year follow-up study.

PubMed

Wang, Ching-Jen

2002-04-01

A retrospective study of 15 patients with 16 knees who underwent osteochondral autografts for focal full thickness articular cartilage defects of the knee with 2- to 4-year follow-up showed 80% good or excellent clinical results. There was no correlation of the clinical results with the underlying diagnoses, including osteonecrosis, osteochondritis dessicans and traumatic cartilage defect, or a size of the lesion smaller than 600 mm(2). However, cartilage lesions larger than 600 mm(2) were associated with increasing fibrous tissue formation and fissuring between the grafts and the host tissues and poor results. The improvement in symptoms appeared time-dependent, ranging from 6 to 16 weeks, suggesting that postoperative protection of the graft is warranted. There was no radiographic progression of degenerative changes of the knee on the medium-term follow-up. Therefore, an autogenous osteochondral graft is considered a good method in the treatment of knees with moderately sized articular cartilage defects.

Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention

PubMed Central

Williams, Monnica T.; Mugno, Beth; Franklin, Martin; Faber, Sonya

2014-01-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The cognitive-behavioral treatment with the most empirical support is currently exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e., symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. PMID:23615340

A Simulation Study on a Single-Unit Wireless EEG Sensor

PubMed Central

Luan, Bo; Sun, Mingui

2015-01-01

Traditional EEG systems are limited when utilized in point-of-care applications due to its immobility and tedious preparation procedures. We are designing a novel device named single-unit wireless EEG sensor to solve these problems. The sensor has a size similar to a U.S. penny. Four electrodes are installed within a 20mm diameter cylinder. It can be applied to scalp in seconds to amplify, digitize and wirelessly transmit EEG. Before the design and construction of an actual sensor, in this paper, we perform a set of simulations to quantitatively study: 1) can the sensor acquire EEG reliably? 2) will the selection of sensor orientation be an important factor to influence signal strength? Our results demonstrate positive answers to these questions. Moreover, the signal sensor acquired appears to be comparable to the signal from the standard 10-20 system. These results warrant the further design and construction of a single-unit wireless EEG sensor. PMID:26207084

Prophylactic low-dose aspirin is effective antithrombotic therapy for combination treatments of thalidomide or lenalidomide in myeloma.

PubMed

Niesvizky, Ruben; Martínez-Baños, Déborah; Jalbrzikowski, Jessica; Christos, Paul; Furst, Jessica; De Sancho, Maria; Mark, Tomer; Pearse, Roger; Mazumdar, Madhu; Zafar, Faiza; Pekle, Karen; Leonard, John; Jayabalan, David; Coleman, Morton

2007-12-01

Multiple myeloma (MM) patients have a propensity for thromboembolic events (TE), and treatment with thalidomide/dexamethasone or lenalidomide/dexamethasone increases this risk. This report describes the use of low-dose aspirin (81 mg) as primary thromboprophylaxis in three series of MM patients receiving thalidomide or lenalidomide with other drugs. In the first regimen (clarithromycin, thalidomide, dexamethasone), initiation of low-dose aspirin negated the occurrence of any further TE. In a second study, prophylactic aspirin given with thalidomide/dexamethasone resulted in a rate of TE similar to that seen with dexamethasone alone (without aspirin). A third study (n = 72) evaluated thrombosis rates with aspirin and a lenalidomide-containing regimen (clarithromycin, lenalidomide, dexamethasone). Of nine occurrences of thromboembolism, five were associated with aspirin interruption or poor compliance. Low-dose aspirin appears to reduce the incidence of thrombosis with these regimens. Routine use of aspirin as antithrombotic prophylaxis in MM patients receiving immunomodulatory drugs with corticosteroids is warranted.

DEFINING AND NEGOTIATING THE SOCIAL VALUE OF RESEARCH IN PUBLIC HEALTH FACILITIES: PERCEPTIONS OF STAKEHOLDERS IN A RESEARCH-ACTIVE PROVINCE OF SOUTH AFRICA

PubMed Central

Lutge, Elizabeth; Slack, Catherine; Wassenaar, Douglas

2016-01-01

This paper reports on qualitative research conducted in KwaZulu-Natal, South Africa, among researchers and gate-keepers of health facilities in the province. Results suggest disparate but not irreconcilable perceptions of the social value of research in provincial health facilities. This study found that researchers tended to emphasise the contribution of research to the generation of knowledge and to the health of future patients while gate-keepers of health facilities tended to emphasise its contribution to the healthcare system and to current patients. Furthermore, relations between research stakeholders were perceived to be somewhat fragile, making it difficult for stakeholders to achieve consensus about the social value of research, as well as on ways to maximise value. Interventions to negotiate a shared perspective on the social value of research would appear to be warranted, and the findings of this study suggest some focus areas for such intervention. PMID:28060430

Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation

PubMed Central

2014-01-01

The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein, 15-30% of calories from fat, and the reminder of calories from carbohydrate. Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training likely maximizes any theoretical benefits of nutrient timing and frequency. However, alterations in nutrient timing and frequency appear to have little effect on fat loss or lean mass retention. Among popular supplements, creatine monohydrate, caffeine and beta-alanine appear to have beneficial effects relevant to contest preparation, however others do not or warrant further study. The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous, and may not improve appearance. Increasing carbohydrate intake at the end of preparation has a theoretical rationale to improve appearance, however it is understudied. Thus, if carbohydrate loading is pursued it should be practiced prior to competition and its benefit assessed individually. Finally, competitors should be aware of the increased risk of developing eating and body image disorders in aesthetic sport and therefore should have access to the appropriate mental health professionals. PMID:24864135

Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation.

PubMed

Helms, Eric R; Aragon, Alan A; Fitschen, Peter J

2014-01-01

The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein, 15-30% of calories from fat, and the reminder of calories from carbohydrate. Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training likely maximizes any theoretical benefits of nutrient timing and frequency. However, alterations in nutrient timing and frequency appear to have little effect on fat loss or lean mass retention. Among popular supplements, creatine monohydrate, caffeine and beta-alanine appear to have beneficial effects relevant to contest preparation, however others do not or warrant further study. The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous, and may not improve appearance. Increasing carbohydrate intake at the end of preparation has a theoretical rationale to improve appearance, however it is understudied. Thus, if carbohydrate loading is pursued it should be practiced prior to competition and its benefit assessed individually. Finally, competitors should be aware of the increased risk of developing eating and body image disorders in aesthetic sport and therefore should have access to the appropriate mental health professionals.

Preparing for the future: a review of tools and strategies to support autonomous goal setting for children and youth with autism spectrum disorders.

PubMed

Hodgetts, Sandra; Park, Elly

2017-03-01

Despite recognized benefits, current clinical practice rarely includes direct input from children and youth with autism spectrum disorder (ASD) in setting rehabilitation goals. This study reviews tools and evidence-based strategies to assist with autonomous goal settings for children and youth with ASD. This study included two components: (1) A scoping review of existing tools and strategies to assist with autonomous goal setting in individuals with ASD and (2) a chart review of inter-disciplinary service plan goals for children and youth with ASD. Eleven data sources, evaluating five different tools to assist with autonomous goal setting for children and youth with ASD, were found. Three themes emerged from the integration of the scoping review and chart review, which are discussed in the paper: (1) generalizability of findings, (2) adaptations to support participation and (3) practice implications. Children and youth with ASD can participate in setting rehabilitation goals, but few tools to support their participation have been evaluated, and those tools that do exist do not align well with current services foci. Visual aids appear to be one effective support, but further research on effective strategies for meaningful engagement in autonomous goal setting for children and youth with ASD is warranted. Implications for rehabilitation Persons with ASD are less self-determined than their peers. Input into one's own rehabilitation goals and priorities is an important component of self-determination. Few tools exist to help engage children and youth with ASD in setting their own rehabilitation goals. An increased focus on identifying, developing and evaluating effective tools and strategies to facilitate engagement of children and youth with ASD in setting their own rehabilitation goals is warranted.

Likelihood of myocardial infarction during stroke rehabilitation preceded by cardiovascular screening and an exercise tolerance test: the Locomotor Experience Applied Post-Stroke (LEAPS) trial.

PubMed

Nadeau, Stephen E; Rose, Dorian Kay; Dobkin, Bruce; Wu, Samuel S; Dai, Yufeng E; Schofield, Richard; Duncan, Pamela W

2014-12-01

Coronary artery disease is highly prevalent in patients with stroke, but because revascularization does not improve major clinical outcomes in patients with stable coronary artery disease relative to intensive medical therapy, routine evaluation for this disease is not warranted in stroke patients. However, it might be warranted in patients destined to undergo vigorous physical therapy. The Locomotor Experience Applied Post-Stroke study, a randomized controlled trial of 408 participants that tested the relative efficacy of two rehabilitation techniques on functional walking level, provided the opportunity to address this question. The study aims to test the efficacy of screening for cardiovascular disease and an exercise tolerance test in assuring safety among patients undergoing vigorous rehabilitation for gait impairment. All participants were screened for serious cardiovascular and pulmonary conditions. At six-weeks poststroke, they also completed a cardiovascular screening inventory and underwent an exercise tolerance test involving bicycle ergometry. Participants received 36, 90-min sessions of a prescribed physical therapy (three per week), initiated at either two-months or six-months poststroke. Twenty-nine participants were excluded on the basis of the cardiac screening questionnaire, and 15 failed the exercise tolerance test for cardiovascular reasons. No participant experienced a cardiac event during a treatment session. Two participants experienced myocardial infarctions, but continued in the trial. In three additional participants, myocardial infarctions caused or contributed to death. The combination of a negative cardiac screen and the absence of exercise tolerance test failure appeared to have a high negative predictive value for cardiac events during treatment, despite the likelihood of a high prevalence of coronary artery disease in our population. © 2014 World Stroke Organization.

Alcohol use and HIV sexual risk among MSM in Chennai, India

PubMed Central

Mimiaga, M J; Thomas, B; Mayer, K H; Reisner, S L; Menon, S; Swaminathan, S; Periyasamy, M; Johnson, C V; Safren, S A

2013-01-01

Summary Men who have sex with men (MSM) in India are a core risk group for HIV. Heavy alcohol consumption is associated with increased sexual risk-taking behaviours in many cultures, in particular among MSM. However, no studies to date have explored alcohol use and HIV risk among MSM in India. MSM in Chennai, India (n = 210) completed an interviewer-administered behavioural and psychosocial assessment. Bivariate and multivariable logistic regression procedures examined behavioural and demographic associations with weekly alcohol consumption. Twenty-eight percent of the sample (n = 58) reported using alcohol at least weekly to the point of being buzzed/intoxicated, which was associated with older age, being married to a woman, being panthi (masculine appearing, predominantly insertive partners) versus kothi (feminine acting/appearing and predominantly receptive partners), weekly tobacco use, unprotected anal sex and unprotected vaginal sex in the three months prior to study enrolment (all P < 0.05). In a multivariable model, unprotected vaginal sex in the previous three months and being married to a women were unique variables associated with weekly alcohol use (all P < 0.01). Further investigation of alcohol use within the context of sexual risk taking is warranted among Indian MSM. Panthis and MSM who are married to women may be particularly likely to benefit from interventions to decrease alcohol intake and concurrent unsafe sex. PMID:21464447

Cognitive Analytic Therapy for Bipolar Disorder: A Pilot Randomized Controlled Trial.

PubMed

Evans, Mark; Kellett, Stephen; Heyland, Simon; Hall, Jo; Majid, Shazmin

2017-01-01

The evidence base for treatment of bipolar affective disorder (BD) demands the evaluation of new psychotherapies in order to broaden patient choice. This study reports on the feasibility, safety, helpfulness and effectiveness of cognitive analytic therapy (CAT). In a pilot randomized controlled trial, BD patients in remission were randomized to either receiving 24 sessions of CAT (n = 9) or treatment as usual (n = 9) and were assessed in terms of symptoms, functioning and service usage over time. In the CAT arm no adverse events occurred, 8/9 completed treatment, 5/8 attended all 24 sessions and 2/8 were categorized as recovered. The most common helpful event during CAT was recognition of patterns in mood variability, with helpfulness themes changing according to phase of therapy. No major differences were found when comparing the arms over time in terms of service usage or psychometric outcomes. The study suggests that conducting further research into the effectiveness of CAT in treating BD is warranted and guidance regarding future trials is provided. Copyright © 2016 John Wiley & Sons, Ltd. Treating BD with CAT appears feasible and safe. Retaining fidelity to the reformulation, recognition and revision structure of CAT appears useful. Participants stated that across the phases of CAT, focussing on patterns of mood variability was consistently helpful. Copyright © 2016 John Wiley & Sons, Ltd.

A VaR Algorithm for Warrants Portfolio

NASA Astrophysics Data System (ADS)

Dai, Jun; Ni, Liyun; Wang, Xiangrong; Chen, Weizhong

Based on Gamma Vega-Cornish Fish methodology, this paper propose the algorithm for calculating VaR via adjusting the quantile under the given confidence level using the four moments (e.g. mean, variance, skewness and kurtosis) of the warrants portfolio return and estimating the variance of portfolio by EWMA methodology. Meanwhile, the proposed algorithm considers the attenuation of the effect of history return on portfolio return of future days. Empirical study shows that, comparing with Gamma-Cornish Fish method and standard normal method, the VaR calculated by Gamma Vega-Cornish Fish can improve the effectiveness of forecasting the portfolio risk by virture of considering the Gamma risk and the Vega risk of the warrants. The significance test is conducted on the calculation results by employing two-tailed test developed by Kupiec. Test results show that the calculated VaRs of the warrants portfolio all pass the significance test under the significance level of 5%.

Exposure to movie smoking, antismoking ads and smoking intensity: an experimental study with a factorial design.

PubMed

Harakeh, Zeena; Engels, Rutger C M E; Vohs, Kathleen; van Baaren, Rick B; Sargent, James

2010-06-01

This study examines whether smoking portrayal in movies or antismoking advertisements affect smoking intensity among young adults. We conducted an experimental study in which 84 smokers were randomly assigned using a two (no-smoking versus smoking portrayal in the movie) by three (two prosocial ads, two antismoking ads or one of each) factorial design. Participants viewed a 60-minute movie with two commercial breaks and afterwards completed a questionnaire. Smoking during the session was allowed and observed. Exposure to the movie with smoking had no effect on smoking intensity. Those who viewed two antismoking ads had significantly lower smoking intensity compared with those who viewed two prosocial ads. There was no interaction between movie smoking and antismoking ads. Baseline CO (carbon monoxide) level had the largest effect on smoking intensity. These findings provide further evidence to support antismoking ads placed with movies because of their possible effect on young adult smoking behaviour. However, caution is warranted, because nicotine dependence appears to be the primary predictor of smoking intensity among young adult smokers in this study.

Exposure to movie smoking, antismoking ads and smoking intensity: an experimental study with a factorial design

PubMed Central

Harakeh, Zeena; Engels, Rutger C M E; Vohs, Kathleen; van Baaren, Rick B; Sargent, James

2013-01-01

Background This study examines whether smoking portrayal in movies or antismoking advertisements affect smoking intensity among young adults. Methods We conducted an experimental study in which 84 smokers were randomly assigned using a two (no-smoking versus smoking portrayal in the movie) by three (two prosocial ads, two antismoking ads or one of each) factorial design. Participants viewed a 60-minute movie with two commercial breaks and afterwards completed a questionnaire. Smoking during the session was allowed and observed. Results Exposure to the movie with smoking had no effect on smoking intensity. Those who viewed two antismoking ads had significantly lower smoking intensity compared with those who viewed two prosocial ads. There was no interaction between movie smoking and antismoking ads. Baseline CO (carbon monoxide) level had the largest effect on smoking intensity. Conclusion These findings provide further evidence to support antismoking ads placed with movies because of their possible effect on young adult smoking behaviour. However, caution is warranted, because nicotine dependence appears to be the primary predictor of smoking intensity among young adult smokers in this study. PMID:20008155

Use of viscous fibres in beverages for appetite control: a review of studies.

PubMed

Ho, Irene H H; Matia-Merino, Lara; Huffman, Lee M

2015-01-01

Dietary fibres, particularly viscous fibres appear to be more effective for appetite control (reduce subjective appetite, energy intake and/or body weight). Three types of viscous fibres, pectin, alginate and cereal beta-glucan, were identified as potential satiety-enhancing ingredients. The aim of this review was to collect evidence from human intervention studies evaluating pectins, alginates and beta-glucans in beverages, liquid preloads and liquid test meals for their satiety effects. Our focused, narrative review of several satiety studies shows an overall consistent result on the effectiveness of pectin, alginate and beta-glucan for appetite control. Beverages or liquid test meals are probably the better delivery mode for these fibres, as their effect on satiety is affected by their physico-chemical properties. Most, if not all, of these reviewed studies gave little or no consideration to the potential effects of common food processing (e.g. pasteurisation, ultra-high temperature process) on the physico-chemical properties of these fibre-containing beverages. This is one of the research gaps we have identified warranting further work, which is likely to be of significance from the industry and consumer perspective.

Adaptation of warrant price with Black Scholes model and historical volatility

NASA Astrophysics Data System (ADS)

Aziz, Khairu Azlan Abd; Idris, Mohd Fazril Izhar Mohd; Saian, Rizauddin; Daud, Wan Suhana Wan

2015-05-01

This project discusses about pricing warrant in Malaysia. The Black Scholes model with non-dividend approach and linear interpolation technique was applied in pricing the call warrant. Three call warrants that are listed in Bursa Malaysia were selected randomly from UiTM's datastream. The finding claims that the volatility for each call warrants are different to each other. We have used the historical volatility which will describes the price movement by which an underlying share is expected to fluctuate within a period. The Black Scholes model price that was obtained by the model will be compared with the actual market price. Mispricing the call warrants will contribute to under or over valuation price. Other variables like interest rate, time to maturity date, exercise price and underlying stock price are involves in pricing call warrants as well as measuring the moneyness of call warrants.

Cyclic Spin Testing of Superalloy Disks With a Dual Grain Microstructure

NASA Technical Reports Server (NTRS)

Gayda, John; Kantzos, Pete

2005-01-01

An aggressive cyclic spin test program was run to verify the reliability of superalloy disks with a dual grain structure, fine grain bore and coarse grain rim, utilizing a disk design with web holes bisecting the grain size transition zone. Results of these tests were compared with conventional disks with uniform grain structures. Analysis of the test results indicated the cyclic performance of disks with a dual grain structure could be estimated to a level of accuracy which does not appear to prohibit the use of this technology in advanced gas turbine engines, although further refinement of lifing methodology is clearly warranted.

Comprehensive Mutation Scanning of LMNA in 268 Patients With Lone Atrial Fibrillation

PubMed Central

Brauch, Katharine M.; Chen, Lin Y.; Olson, Timothy M.

2009-01-01

Atrial fibrillation (AF) is a heritable, genetically heterogeneous disorder. To identify gene defects that cause or confer susceptibility to AF, a cohort of 268 unrelated patients with idiopathic forms of familial and sporadic AF was recruited. LMNA, encoding the nuclear membrane proteins, lamin A/C, was selected as a candidate gene for lone AF based on its established association with a syndrome of dilated cardiomyopathy, conduction system disease, and AF. Comprehensive mutation scanning identified only 1 potentially pathogenic mutation. In conclusion, LMNA mutations rarely cause lone AF and routine genetic testing of LMNA in these patients does not appear warranted. PMID:19427440

Effects of self-hypnosis training and cognitive restructuring on daily pain intensity and catastrophizing in individuals with multiple sclerosis and chronic pain.

PubMed

Jensen, Mark P; Ehde, Dawn M; Gertz, Kevin J; Stoelb, Brenda L; Dillworth, Tiara M; Hirsh, Adam T; Molton, Ivan R; Kraft, George H

2011-01-01

Fifteen adults with multiple sclerosis were given 16 sessions of treatment for chronic pain that included 4 sessions each of 4 different treatment modules: (a) an education control intervention; (b) self-hypnosis training (HYP); (c) cognitive restructuring (CR); and (d) a combined hypnosis-cognitive restructuring intervention (CR-HYP). The findings supported the greater beneficial effects of HYP, relative to CR, on average pain intensity. The CR-HYP treatment appeared to have beneficial effects greater than the effects of CR and HYP alone. Future research examining the efficacy of an intervention that combines CR and HYP is warranted.

St. John's wort: a new alternative for depression?

PubMed

Josey, E S; Tackett, R L

1999-03-01

The primary purpose of this article is to review the existing literature concerning the therapeutic uses, adverse effects, and possible drug interactions of St. John's wort (Hypericum perforatum) as compared to other antidepressant medications. Reference material was obtained through database searches with time restrictions of 1985 to the present. Studies selected were those written in the English language which compared the role of St. John's wort, tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin-selective reuptake inhibitors in the treatment of depression. Other studies were selected based on their evaluation of the safety and efficacy of St. John's wort as an antidepressant for a minimum of four weeks. A review of existing literature recognized nine clinical trials that reported the efficacy of St. John's wort as compared to placebo and to other antidepressant medications. Of these nine, four controlled studies were chosen based upon their large patient populations and their consistency in brand and dosage of St. John's wort used. These four studies demonstrated that St. John's wort was as effective as other antidepressant medications and more effective than placebo, as the clinical symptoms of depression greatly decreased upon administration of H. perforatum. The side-effect profile of H. perforatum at this time appears to be superior to any current U.S.-approved antidepressant medication. From the existing literature, St. John's wort appears to be a safe and effective alternative in the treatment of depression. Tricylic antidepressants and monoamine oxidase inhibitors can produce serious cardiac side-effects, such as tachycardia and postural hypotension, and many unwanted anticholinergic side-effects, including dry mouth and constipation. St. John's wort has proven to be free of any cardiac, as well as anticholinergic, side-effects normally seen with antidepressant medications. Based upon limited studies, St. John's wort appears to be an acceptable alternative to traditional antidepressant therapy, although trials on a larger scale are warranted in this area. Hypericum is available to the lay public as an over-the-counter preparation and may be misused if not fully understood.

Nano-metal Oxides: Exposure and Engineering Control Assessment

PubMed Central

Garcia, Alberto; Sparks, Christopher; Martinez, Kenneth; Topmiller, Jennifer L.; Eastlake, Adrienne; Geraci, Charles L.

2017-01-01

This paper discusses the evaluation of a facility that produces high quality engineered nanomaterials. These ENMs consist of various metals including iron, nickel, silver, manganese, and palladium. Although occupational exposure levels are not available for these metals, studies have indicated that it may be prudent to keep exposures to the nano-scale metal as low as possible. Previous In vitro studies indicated that in comparison with a material’s larger (parent) counterpart, nanomaterials can move easily through cell membranes and can cause severe toxic effects on human health. The in vitro studies showed that the toxicological effects specific to exposure to nanoscale nickel oxide and nickel have been found to be more inflammatory and toxic than larger-sized nickel particles and can decrease cell metabolic activity, arrest the G2-M cell cycle, and increase cell death. An in vitro study on exposure to iron nanoparticles indicated that the reactive oxygen species produced by exposure may increase cell permeability thereby increasing the potential for vascular movement. Much of the data available on palladium focus on dermal or ingestion exposure; the chronic effects are not well understood. Given the available limited data on the metals evaluated, caution is warranted. One should always keep in mind that the current OELs were not developed specifically for nanoscale particles. With limited data suggesting that certain nanoparticles may be more toxic than the larger counterparts of the same material; employers should attempt to control emissions of these particles at the source, to limit the potential for exposure. Evidence suggests that in general some nanomaterials can be more toxic than their macro-scale counterparts, and therefore caution is warranted. It appears that the personal protective equipment utilized by the employee was appropriate for this type of operation. It should be noted that the use of respiratory protection should not be used as sole protection for any worker, but providing a fit-tested respirator will serve to further decrease the potential for exposure. Instead, it is recommended to control the dispersion of product at the source using local exhaust ventilation, ventilated containment, or fume hoods. Data obtained from the direct reading instruments suggest that reactor cleanout increased the overall particle concentration in the immediate area. However, it does not appear that these concentrations affect areas outside of the production floor. As the distance between the reactor and the sample location increased, the observed particle number concentrations decreased, creating a concentration gradient with respect to the reactor. PMID:28609256

Conflict of interest and disclosure policies in psychiatry and medicine: a comparative study of peer-reviewed journals.

PubMed

Khurana, Gauri; Henderson, Schuyler; Walter, Garry; Martin, Andrés

2012-01-01

The authors reviewed and characterized conflict of interest (COI) and disclosure policies published in peer-reviewed psychiatric and nonpsychiatric journals. The authors examined peer-reviewed publications in the psychiatric (N=20) and nonpsychiatric (N=20) literature. Using qualitative and quantitative approaches, they designed an instrument to compare COI and disclosure policies appearing in print or journal websites between January and May 2009. All journals published COI/disclosure policies that were accessible in print and online. There was substantial variability in policies, but little variability appeared to be field-specific. Psychiatric journals were more likely to request "complete" disclosure, and nonpsychiatric journals to request "relevant" disclosure, but medical journals tended to provide more detailed information about what could constitute a potential conflict and asked for broader, potentially relevant funding sources. Nonpsychiatric journals were more likely to give examples in their policies. Psychiatric journals were more likely to publish disclosures. This preliminary study suggests that there are discrepancies in the disclosure and COI information that journals request from authors. By and large, such discrepancies are not substantially different between psychiatric and nonpsychiatric journals. Challenges in codifying COI policies and creating standardized approaches across periodicals and across disciplines may reflect ongoing debates about what exactly constitutes a COI, what needs to be disclosed, and who is responsible for disclosing. Further study is warranted into how journals convey COI policies and how such policies can be optimized.

Fruit, Vegetable and Dietary Carotenoid Intakes Explain Variation in Skin-Color in Young Caucasian Women: A Cross-Sectional Study.

PubMed

Pezdirc, Kristine; Hutchesson, Melinda J; Whitehead, Ross; Ozakinci, Gozde; Perrett, David; Collins, Clare E

2015-07-15

Fruit and vegetables contain carotenoid pigments, which accumulate in human skin, contributing to its yellowness. This effect has a beneficial impact on appearance. The aim was to evaluate associations between diet (fruit, vegetable and dietary carotenoid intakes) and skin color in young women. Ninety-one Caucasian women (Median and Interquartile Range (IQR) age 22.1 (18.1-29.1) years, BMI 22.9 (18.5-31.9) kg/m2) were recruited from the Hunter region (Australia). Fruit, vegetable and dietary carotenoid intakes were estimated by a validated food frequency questionnaire. Skin color was measured at nine body locations (sun exposed and unexposed sites) using spectrophotometry. Multiple linear regression was used to assess the relationship between fruit and vegetable intakes and skin yellowness adjusting for known confounders. Higher combined fruit and vegetable intakes (β = 0.8, p = 0.017) were associated with higher overall skin yellowness values. Higher fruit combined fruit and vegetable intakes (β = 1.0, p = 0.004) were associated with increased unexposed skin yellowness. Combined fruit and vegetables plus dietary carotenoid intakes contribute to skin yellowness in young Caucasian women. Evaluation of interventions using improvements in appearance as an incentive for increasing fruit and vegetable consumption in young women is warranted.

Fruit, Vegetable and Dietary Carotenoid Intakes Explain Variation in Skin-Color in Young Caucasian Women: A Cross-Sectional Study

PubMed Central

Pezdirc, Kristine; Hutchesson, Melinda J.; Whitehead, Ross; Ozakinci, Gozde; Perrett, David; Collins, Clare E.

2015-01-01

Fruit and vegetables contain carotenoid pigments, which accumulate in human skin, contributing to its yellowness. This effect has a beneficial impact on appearance. The aim was to evaluate associations between diet (fruit, vegetable and dietary carotenoid intakes) and skin color in young women. Ninety-one Caucasian women (Median and Interquartile Range (IQR) age 22.1 (18.1–29.1) years, BMI 22.9 (18.5–31.9) kg/m2) were recruited from the Hunter region (Australia). Fruit, vegetable and dietary carotenoid intakes were estimated by a validated food frequency questionnaire. Skin color was measured at nine body locations (sun exposed and unexposed sites) using spectrophotometry. Multiple linear regression was used to assess the relationship between fruit and vegetable intakes and skin yellowness adjusting for known confounders. Higher combined fruit and vegetable intakes (β = 0.8, p = 0.017) were associated with higher overall skin yellowness values. Higher fruit combined fruit and vegetable intakes (β = 1.0, p = 0.004) were associated with increased unexposed skin yellowness. Combined fruit and vegetables plus dietary carotenoid intakes contribute to skin yellowness in young Caucasian women. Evaluation of interventions using improvements in appearance as an incentive for increasing fruit and vegetable consumption in young women is warranted. PMID:26184306

On the relationship between mouth opening and "broken mirror neurons" in autistic individuals.

PubMed

Pascolo, P B; Cattarinussi, A

2012-02-01

Electromyographies of the mylohyoid muscle (MH) during the execution of the goal-oriented action "grasping to eat" have been used to determine the time relationship between the opening of the mouth and the beginning of the movement. This has been used to distinguish the behaviour of typical developing (TD) children from that of highly functioning autistic (ASD) individuals. The results of previous studies appeared to provide evidence of a deficit in action chain organization in ASD subjects and prompted the hypothesis of a "broken" mirror neuron system (MNS) for these individuals. Our results show the MH activation timing is not reliable in discriminating between TD and ASD children and the distance between the food and the subject plays a key role on the MH activation timing and cannot be neglected when analysing these type of data. The preliminary investigation on the effects of external perturbations also shows that these might have an effect on the results and further investigations are warranted. It appears that there is not enough evidence to support a link between ASD and a broken mirror network system (MNS), and the experimental results must be carefully interpreted before developing therapeutic or rehabilitative protocols. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prostate cancer progression and mortality: a review of diet and lifestyle factors.

PubMed

Peisch, Sam F; Van Blarigan, Erin L; Chan, June M; Stampfer, Meir J; Kenfield, Stacey A

2017-06-01

To review and summarize evidence on the role of diet and lifestyle factors and prostate cancer progression, with a specific focus on habits after diagnosis and the risk of subsequent disease recurrence, progression, or death. Given the well-documented heterogeneity of prostate cancer and the long survivorship of the majority of diagnoses, our goal was to summarize and describe modifiable risk factors for clinically relevant prostate cancer. We focused where possible on epidemiologic studies of post-diagnostic habits and prostate cancer progression, defined as recurrence (e.g., PSA risk, secondary treatment), metastasis, or death. Where data were limited, we also describe evidence on risk factors and indicators of prostate cancer aggressiveness at diagnosis. A variety of dietary and lifestyle factors appear to affect prostate cancer progression. Several generally widely recommended lifestyle factors such as not smoking, maintaining a healthy body weight, and regular vigorous physical exercise also appear to affect prostate cancer progression. Several dietary factors, such as tomato sauce/lycopene, cruciferous vegetables, healthy sources of vegetable fats, and coffee, may also have a role in reducing risk of prostate cancer progression. Diet and lifestyle factors, in particular exercise and smoking cessation, may reduce the risk of prostate cancer progression and death. These promising findings warrant further investigation, as their overall impact might be large.

Familial expressed emotion: outcome and course of Israeli patients with schizophrenia.

PubMed

Marom, Sofi; Munitz, Hanan; Jones, Peter B; Weizman, Abraham; Hermesh, Haggai

2002-01-01

We investigated the validity of expressed emotion (EE) in Israel. The study sample consisted of 108 patients with schizophrenia and 15 with schizoaffective disorder, and their key relatives. EE was rated with the Five Minute Speech Sample (FMSS). Patient households were categorized by EE and its two components: criticism and emotional overinvolvement. Patients were rated with the Brief Psychiatric Rating Scale (BPRS) at admission, at discharge, and 6 months after discharge. Readmissions were determined over a 9-month period. High EE and particularly high criticism were significantly associated with poorer outcome (higher rate of and earlier readmissions, and higher BPRS score at followup) and worse illness course (higher annual number of prior psychiatric hospital admissions). Odds ratios between high EE and high criticism and readmission were 2.6 and 3.5, respectively. The strongest predictor of earlier readmission was the interaction of high criticism x poor compliance with medication. The results converge to further confirm the notion that familial EE is a valid crosscultural predictor of the clinical course of schizophrenia. Moreover, EE has predictive power in very chronic samples. Criticism appears to be the crucial EE component linked with short-term outcome. Treatment aimed at reducing high criticism is warranted. The FMSS appears to have predictive validity.

White Blood Cell Count and Total and Cause-Specific Mortality in the Women's Health Initiative.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Manson, JoAnn E; Lessin, Lawrence; Lin, Juan; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

2017-07-01

White blood cell (WBC) count appears to predict total mortality and coronary heart disease (CHD) mortality, but it is unclear to what extent the association reflects confounding by smoking, underlying illness, or comorbid conditions. We used data from the Women's Health Initiative to examine the associations of WBC count with total mortality, CHD mortality, and cancer mortality. WBC count was measured at baseline in 160,117 postmenopausal women and again in year 3 in 74,375 participants. Participants were followed for a mean of 16 years. Cox proportional hazards models were used to estimate the relative mortality hazards associated with deciles of baseline WBC count and of the mean of baseline + year 3 WBC count. High deciles of both baseline and mean WBC count were positively associated with total mortality and CHD mortality, whereas the association with cancer mortality was weaker. The association of WBC count with mortality was independent of smoking and did not appear to be influenced by previous disease history. The potential clinical utility of this common laboratory test in predicting mortality risk warrants further study. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Extended thromboprophylaxis in the acutely ill medical patient after hospitalization - a paradigm shift in post-discharge thromboprophylaxis.

PubMed

Mahan, Charles E; Burnett, Allison E; Fletcher, Meghan L; Spyropoulos, Alex C

2018-02-01

Venous thromboembolism (VTE) is a significant healthcare burden with approximately 900,000 events annually in the United States, over half of which are healthcare-associated. This number is anticipated to double by 2050. Group prophylaxis strategies confined to the inpatient setting appear to have minimal impact on the reduction of post-discharge VTE in medically ill patients due to shortened lengths of stay and a heterogenous population that includes patients at low risk for VTE. In accordance with current guideline recommendations, very few (<5%) medically ill patients are discharged with extended prophylaxis, which potentially creates a clinical gap for at-risk patients as VTE risk has been shown to persist for up to 90 days. Initial studies of extended thromboprophylaxis in acutely ill medical patients with enoxaparin, rivaroxaban and apixaban showed little to no benefit towards VTE reduction that was consistently outweighed by increased bleeding. The more recent APEX study that compared betrixaban to enoxaparin in an enriched patient population at high-risk for VTE was the first study of extended thromboprophylaxis that showed similar efficacy in VTE prevention without an increase in major bleeding. Based on the APEX results, betrixaban recently gained FDA approval for extended thromboprophylaxis in acutely ill medical patients. Recognition that up to half of medically ill patients are not at sufficient risk to warrant thromboprophylaxis has driven extensive research towards development of scientifically derived and validated VTE risk assessment models intended to identify patients who do not warrant prophylaxis, as well as those at high risk who may derive benefit from extended thromboprophylaxis. This article will review prior and ongoing extended thromboprophylaxis studies, VTE and bleed risk assessment models, incorporation of biomarkers in VTE risk assessment and key issues in the paradigm shift towards individualized VTE prophylaxis in acutely ill medical patients.

Misinterpretation of facial expression: a cross-cultural study.

PubMed

Shioiri, T; Someya, T; Helmeste, D; Tang, S W

1999-02-01

Accurately recognizing facial emotional expressions is important in psychiatrist-versus-patient interactions. This might be difficult when the physician and patients are from different cultures. More than two decades of research on facial expressions have documented the universality of the emotions of anger, contempt, disgust, fear, happiness, sadness, and surprise. In contrast, some research data supported the concept that there are significant cultural differences in the judgment of emotion. In this pilot study, the recognition of emotional facial expressions in 123 Japanese subjects was evaluated using the Japanese and Caucasian Facial Expression of Emotion (JACFEE) photos. The results indicated that Japanese subjects experienced difficulties in recognizing some emotional facial expressions and misunderstood others as depicted by the posers, when compared to previous studies using American subjects. Interestingly, the sex and cultural background of the poser did not appear to influence the accuracy of recognition. The data suggest that in this young Japanese sample, judgment of certain emotional facial expressions was significantly different from the Americans. Further exploration in this area is warranted due to its importance in cross-cultural clinician-patient interactions.

Xylitol as a prophylaxis for acute otitis media: systematic review.

PubMed

Danhauer, Jeffrey L; Johnson, Carole E; Corbin, Nicole E; Bruccheri, Kaitlyn G

2010-10-01

A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects.

Exploring the causal machinery behind sex ratios at birth: does hepatitis B play a role?

PubMed

Hamoudi, Amar

2010-01-01

The causal machinery underlying sex determination is directly relevant to many questions relating gender and family composition to social and economic outcomes. In recent work, Oster highlighted a correlation between parental hepatitis B carrier status and sex of the child. One of her analyses went further, speaking directly to causality. That analysis appeared to have answered an important question that had remained unresolved in medical and biological literatures—namely, does chronic infection with hepatitis B cause male‐skewed sex ratios at birth? Oster’s creative empirical analysis appeared to suggest that it does; however, in this article I reassess the result and present evidence that, at the very least, the question remains open. Further investigation into questions around the causal machinery of sex determination is warranted in the social science literature, as well as in that of biology and medicine. However, my results suggest that it is extremely unlikely that chronic hepatitis B infection plays a biologically significant role.

Three-Channeled Aortic Dissection in a Patient without Marfan Syndrome

PubMed Central

Arita, Yoshie Inoue; Yamamoto, Takeshi; Hosokawa, Yusuke; Fujii, Masahiro; Nitta, Takashi; Shimizu, Wataru

2017-01-01

A 64-year-old man was admitted for evaluation of back pain. He did not have a Marfan syndrome (MFS)-like appearance, and had a history of a type B aortic dissection and total arch replacement. A connective tissue disorder had been suspected because of the histologic findings of the resected aortic wall. On admission, a computed tomography (CT) scan demonstrated a three-channeled aortic dissection (3ch-AD) measuring 63 mm in diameter. We planned to perform elective surgery during his hospitalization. On the fourth hospital day, he complained of severe back pain, and enhanced CT scan revealed an aortic rupture. The patients with 3ch-AD often have MFS. However, even if they do not have an MFS-like appearance, clinicians should consider fragility of the aortic wall in patients with 3ch-AD. If the aortic diameter is enlarged, early surgery is recommended. In particular, if a connective tissue disorder is obvious or suspected, emergent surgery is warranted. PMID:29187676

19 CFR 162.12 - Service of search warrant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Service of search warrant. 162.12 Section 162.12 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Search Warrants § 162.12 Service of search warrant. A...

Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis.

PubMed

Galli, Federica; Lodi, Giovanni; Sardella, Andrea; Vegni, Elena

2017-03-01

Background Burning mouth syndrome (BMS) is a chronic medical condition characterised by hot, painful sensations in the lips, oral mucosa, and/or tongue mucosa. On examination, these appear healthy, and organic causes for the pain cannot be found. Several studies have yielded scant evidence of the involvement of psychological and/or psychopathological factors, and several have outlined a model for the classification of BMS. Aim This review aims to provide a systematic review of research examining the psychological, psychiatric, and/or personality factors linked to BMS. Findings Fourteen controlled studies conducted between 2000 and the present were selected based on stringent inclusion/exclusion criteria. All studies but one reported at least some evidence for the involvement of psychological factors in BMS. Anxiety and depression were the most common and the most frequently studied psychopathological disorders among BMS patients. Discussion and conclusion Anxiety and depression play critical roles in this condition. Evidence on the role of personality characteristics of BMS patients has also been produced by a few studies. Further studies on the role of specific psychological factors in BMS are warranted, but the importance of a multidisciplinary approach (medical and psychological) to BMS is no matter of discussion.

25 CFR 11.1101 - Warrant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Warrant. 11.1101 Section 11.1101 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Minor-in-Need-of-Care Procedure § 11.1101 Warrant. The children's court may issue a warrant, directing that...

A review on Black-Scholes model in pricing warrants in Bursa Malaysia

NASA Astrophysics Data System (ADS)

Gunawan, Nur Izzaty Ilmiah Indra; Ibrahim, Siti Nur Iqmal; Rahim, Norhuda Abdul

2017-01-01

This paper studies the accuracy of the Black-Scholes (BS) model and the dilution-adjusted Black-Scholes (DABS) model to pricing some warrants traded in the Malaysian market. Mean Absolute Error (MAE) and Mean Absolute Percentage Error (MAPE) are used to compare the two models. Results show that the DABS model is more accurate than the BS model for the selected data.

17 CFR 270.10f-2 - Exercise of warrants or rights received on portfolio securities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 3 2013-04-01 2013-04-01 false Exercise of warrants or rights... Exercise of warrants or rights received on portfolio securities. Any purchase or other acquisition of securities by a registered investment company pursuant to the exercise of warrants or rights to subscribe to...

17 CFR 270.10f-2 - Exercise of warrants or rights received on portfolio securities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 3 2011-04-01 2011-04-01 false Exercise of warrants or rights... Exercise of warrants or rights received on portfolio securities. Any purchase or other acquisition of securities by a registered investment company pursuant to the exercise of warrants or rights to subscribe to...

17 CFR 270.10f-2 - Exercise of warrants or rights received on portfolio securities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 3 2012-04-01 2012-04-01 false Exercise of warrants or rights... Exercise of warrants or rights received on portfolio securities. Any purchase or other acquisition of securities by a registered investment company pursuant to the exercise of warrants or rights to subscribe to...

17 CFR 270.10f-2 - Exercise of warrants or rights received on portfolio securities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 4 2014-04-01 2014-04-01 false Exercise of warrants or rights... Exercise of warrants or rights received on portfolio securities. Any purchase or other acquisition of securities by a registered investment company pursuant to the exercise of warrants or rights to subscribe to...

17 CFR 270.10f-2 - Exercise of warrants or rights received on portfolio securities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Exercise of warrants or rights... Exercise of warrants or rights received on portfolio securities. Any purchase or other acquisition of securities by a registered investment company pursuant to the exercise of warrants or rights to subscribe to...

The effect of endometrial scratch on natural-cycle cryopreserved embryo transfer outcomes: a randomized controlled study.

PubMed

Mak, Jennifer Sze Man; Chung, Cathy Hoi Sze; Chung, Jacqueline Pui Wah; Kong, Grace Wing Shan; Saravelos, Sotirios H; Cheung, Lai Ping; Li, Tin-Chiu

2017-07-01

The benefit of endometrial scratch (ES) prior to embryo transfer is controversial. Systemic analysis has confirmed its potential benefit, especially in women with repeated IVF failures, yet most studies have focused on fresh embryo transfer, and its effect on vitrified-warmed embryo transfer (FET) cycles is yet to be explored. We hereby present our prospective, double-blind, randomized controlled study on the evaluation of the implantation and pregnancy rate after ES prior to natural-cycle FET. A total of 299 patients underwent natural-cycle FET and were randomized to receive ES (n = 115) or endocervical manipulation as control (n = 114) prior to FET cycle, and a total of 196 patients had embryo transfer (93 patients in each group). Our study showed no significant difference in the implantation and pregnancy rate, as well as the clinical and ongoing pregnancy or live birth rates between the two groups. It appears that ES does not have any beneficial effect on an unselected group of women undergoing FET in natural cycles. Further studies on its effect in women with recurrent implantation failure after IVF are warranted. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Authorship Inflation in Medical Publications.

PubMed

Tilak, Gaurie; Prasad, Vinay; Jena, Anupam B

2015-01-01

The number of authors per manuscript in peer-reviewed medical journals has increased substantially in the last several decades. Several reasons have been offered to explain this authorship growth, including increased researcher collaboration, honorary authorship driven by increased pressures for funding and promotion, the belief that including senior authors will facilitate publication, and the growing complexity of medical research. It is unknown, however, whether authorship has grown over time due to growing complexity of published academic articles, in which case growth could be warranted, or whether it has grown due to pressures of funding and academic promotion, which have created "authorship inflation." To answer this question, we analyzed data on authorship count, study type, and size of study population for the first 50 original articles published in each decade during 1960-2010 in 3 major medical journals. Within each type of study we considered (eg, randomized trials, observational studies, etc), average authorship rose more than 3-fold during this period. Similar growth persisted after adjustment for changes in study population sizes over time. Our findings suggest that increasing research complexity is an inadequate explanation for authorship growth. Instead, growth in authorship appears inflationary. © The Author(s) 2015.

Pericoronitis: a reappraisal of its clinical and microbiologic aspects.

PubMed

Nitzan, D W; Tal, O; Sela, M N; Shteyer, A

1985-07-01

Pericoronitis is an infectious disease of the operculum overlying an erupting or semi-impacted tooth. It manifests itself mainly in late adolescence and young adulthood and nearly always occurs around the lower third molar. The distinctive location, age, clinical picture, and link with predisposing factors warranted a reappraisal of pericoronitis and its etiology. Spirochetes and fusobacteria proved prevalent at all stages of the disease. The presence of these microbacteria may provide a clue as to the late appearance, particular location, and singular clinical picture of pericoronitis. The fact that spirochetes and fusobacteria are also found in acute necrotizing ulcerative gingivitis, and have been associated with alveolar osteitis, indicates a possible relationship between these disorders and pericoronitis.

Assessing the robustness of quantitative fatty acid signature analysis to assumption violations

USGS Publications Warehouse

Bromaghin, Jeffrey F.; Budge, Suzanne M.; Thiemann, Gregory W.; Rode, Karyn D.

2016-01-01

In most QFASA applications, investigators will generally have some knowledge of the prey available to predators and be able to assess the completeness of prey signature data and sample additional prey as necessary. Conversely, because calibration coefficients are derived from feeding trials with captive animals and their values may be sensitive to consumer physiology and nutritional status, their applicability to free-ranging animals is difficult to establish. We therefore recommend that investigators first make any improvements to the prey signature data that seem warranted and then base estimation on the Aitchison distance measure, as it appears to minimize risk from violations of the assumption that is most difficult to verify.

Ulcer disease of trout

USGS Publications Warehouse

Fish, F.F.

1934-01-01

During the summer of 1933, lesions of a disease were noted among some fingerling brook, rainbow, blackspotted, and lake trout at the Cortland (New York) trout hatchery. Although these lesions bore a marked superficial resemblance to those of furunculosis, they were sufficiently atypical to warrant further investigation. A more detailed examination of the lesions proved them to be of a distinct disease, which for lack of a better name is herein called "ulcer disease," for the lesions closely resemble those described by Calkins (1899) under this name. Because of the marked resemblance to furunculosis, ulcer disease has not been generally recognized by trout culturists, and any ulcer appearing on fish has been ascribed by them to furunculosis without further question.

Computed tomographic features of canine nonparenchymal hemangiosarcoma.

PubMed

Fukuda, Shoko; Kobayashi, Tetsuya; Robertson, Ian D; Oshima, Fukiko; Fukazawa, Eri; Nakano, Yuko; Ono, Shin; Thrall, Donald E

2014-01-01

The purpose of this retrospective study was to describe pre- and postcontrast computed tomographic (CT) characteristics of confirmed nonparenchymal hemangiosarcoma in a group of dogs. Medical records were searched during the period of July 2003 and October 2011 and dogs with histologically confirmed nonparenchymal hemangiosarcoma and pre- and postcontrast CT images were recruited. Two observers recorded a consensus opinion for the following CT characteristics for each dog: largest transverse tumor diameter, number of masses, general tumor shape, character of the tumor margin, precontrast appearance, presence of dystrophic calcification, presence of postcontrast enhancement, pattern of postcontrast enhancement, presence of regional lymphadenopathy, and presence of associated cavitary fluid. A total of 17 dogs met inclusion criteria. Tumors were located in the nasal cavity, muscle, mandible, mesentery, subcutaneous tissue, and retroperitoneal space. Computed tomographic features of nonparenchymal hemangiosarcoma were similar to those of other soft tissue sarcomas, with most tumors being heterogeneous in precontrast images, invasive into adjacent tissue, and heterogeneously contrast enhancing. One unexpected finding was the presence of intense foci of contrast enhancement in 13 of the 17 tumors (76%). This appearance, which is not typical of other soft tissue sarcomas, was consistent with contrast medium residing in vascular channels. Findings indicated that there were no unique distinguishing CT characteristics for nonparenchymal hemangiosarcoma in dogs; however, the presence of highly attenuating foci of contrast enhancement may warrant further investigation in prospective diagnostic sensitivity and treatment outcome studies. © 2014 American College of Veterinary Radiology.

Barriers to the medication error reporting process within the Irish National Ambulance Service, a focus group study.

PubMed

Byrne, Eamonn; Bury, Gerard

2018-02-08

Incident reporting is vital to identifying pre-hospital medication safety issues because literature suggests that the majority of errors pre-hospital are self-identified. In 2016, the National Ambulance Service (NAS) reported 11 medication errors to the national body with responsibility for risk management and insurance cover. The Health Information and Quality Authority in 2014 stated that reporting of clinical incidents, of which medication errors are a subset, was not felt to be representative of the actual events occurring. Even though reporting systems are in place, the levels appear to be well below what might be expected. Little data is available to explain this apparent discrepancy. To identify, investigate and document the barriers to medication error reporting within the NAS. An independent moderator led four focus groups in March of 2016. A convenience sample of 18 frontline Paramedics and Advanced Paramedics from Cork City and County discussed medication errors and the medication error reporting process. The sessions were recorded and anonymised, and the data was analysed using a process of thematic analysis. Practitioners understood the value of reporting errors. Barriers to reporting included fear of consequences and ridicule, procedural ambiguity, lack of feedback and a perceived lack of both consistency and confidentiality. The perceived consequences for making an error included professional, financial, litigious and psychological. Staff appeared willing to admit errors in a psychologically safe environment. Barriers to reporting are in line with international evidence. Time constraints prevented achievement of thematic saturation. Further study is warranted.

Italian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS)

PubMed Central

Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico

2015-01-01

Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893

Developmental immunotoxicity of chemicals in rodents and its possible regulatory impact.

PubMed

Hessel, Ellen V S; Tonk, Elisa C M; Bos, Peter M J; van Loveren, Henk; Piersma, Aldert H

2015-01-01

Around 25% of the children in developed countries are affected with immune-based diseases. Juvenile onset diseases such as allergic, inflammatory and autoimmune diseases have shown increasing prevalences in the last decades. The role of chemical exposures in these phenomena is unclear. It is thought that the developmental immune system is more susceptible to toxicants than the mature situation. Developmental immunotoxicity (DIT) testing is nowadays not or minimally included in regulatory toxicology requirements. We reviewed whether developmental immune parameters in rodents would provide relatively sensitive endpoints of toxicity, whose inclusion in regulatory toxicity testing might improve hazard identification and risk assessment of chemicals. For each of the nine reviewed toxicants, the developing immune system was found to be at least as sensitive or more sensitive than the general (developmental) toxicity parameters. Functional immune (antigen-challenged) parameters appear more affected than structural (non-challenged) immune parameters. Especially, antibody responses to immune challenges with keyhole limpet hemocyanine or sheep red blood cells and delayed-type hypersensitivity responses appear to provide sensitive parameters of developmental immune toxicity. Comparison with current tolerable daily intakes (TDI) and their underlying overall no observed adverse effect levels showed that for some of the compounds reviewed, the TDI may need reconsideration based on developmental immune parameters. From these data, it can be concluded that the developing immune system is very sensitive to the disruption of toxicants independent of study design. Consideration of including functional DIT parameters in current hazard identification guidelines and wider application of relevant study protocols is warranted.

Breastfeeding knowledge, attitudes, prior exposure, and intent among undergraduate students.

PubMed

Kavanagh, Katherine F; Lou, Zixin; Nicklas, Jennifer C; Habibi, Mona F; Murphy, Lee T

2012-11-01

Understanding breastfeeding knowledge, attitudes, and exposures among nonpregnant youth who are likely to be future parents may provide significant pathways to successfully increasing breastfeeding as the normal, accepted way of feeding infants. However, based on a recent review of the literature, only 3 studies have assessed these factors in nonpregnant, young adults in the United States in the past 10 years. The objective of this study was to gather more recent data regarding breastfeeding knowledge, attitudes, and prior exposure among undergraduate university students. This was a cross-sectional survey, conducted in November 2010. A convenience sample, consisting of undergraduates in attendance in 2 sections of an introductory nutrition class at a large research university, was used for this project (N = 248). Breastfeeding knowledge was relatively good. However, overall breastfeeding attitudes were more neutral, which appeared to be explained by the belief that breastfeeding is painful, restrictive, and inconvenient, both in general and specifically for the working mother. Though support for breastfeeding in public was low, men were significantly less likely than women to believe it to be embarrassing or unacceptable. In addition, breastfeeding attitudes were more positive among older students and those who were breastfed as infants. Those who were breastfed as infants were also significantly more likely to intend to breastfeed future children. Though this sample indicates good breastfeeding knowledge, attitudes were more neutral, and support for breastfeeding in public appears low. This finding is contradictory and warrants further exploration.

32 CFR Appendix D to Part 275 - Obtaining Access By Search Warrant

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Obtaining Access By Search Warrant D Appendix D... OF 1978 Pt. 275, App. D Appendix D to Part 275—Obtaining Access By Search Warrant A. A Government... named in the attached search warrant were obtained by this [DoD office or activity] on [date] for the...

Clinical profile of motor neuron disease patients with lower urinary tract symptoms and neurogenic bladder.

PubMed

Vázquez-Costa, Juan Francisco; Arlandis, Salvador; Hervas, David; Martínez-Cuenca, Esther; Cardona, Fernando; Pérez-Tur, Jordi; Broseta, Enrique; Sevilla, Teresa

2017-07-15

Lower urinary tract symptoms (LUTS) are frequent in motor neuron disease (MND) patients, but clinical factors related to them are unknown. We describe differences in LUTS among MND phenotypes and their relationship with other clinical characteristics, including prognosis. For this study, we collected clinical data of a previously published cohort of patients diagnosed with classical amyotrophic lateral sclerosis (cALS), progressive muscular atrophy (PMA) or primary lateral sclerosis (PLS) with and without LUTS. Familial history was recorded and the C9ORF72 expansion was analysed in the entire cohort. Patients were followed-up for survival until August 2016. Fifty-five ALS patients (37 cALS, 10 PMA and 8 PLS) were recruited. Twenty-four reported LUTS and neurogenic bladder (NB) could be demonstrated in nine of them. LUTS were not influenced by age, phenotype, disability, cognitive or behavioural impairment, or disease progression, but female sex appeared to be a protective factor (OR=0.39, p=0.06). Neither family history nor the C9ORF72 expansion was linked to LUTS or NB. In the multivariate analysis, patients reporting LUTS early in the disease course tended to show poorer survival. In this study, LUTS appear to be more frequent in male MND patients, but are not related to age, clinical or genetic characteristics. When reported early, LUTS could be a sign of rapid disease spread and poor prognosis. Further prospective longitudinal and neuroimaging studies are warranted to confirm this hypothesis. Copyright © 2017 Elsevier B.V. All rights reserved.

An exploratory dimensional approach to premenstrual manifestation of obsessive-compulsive disorder symptoms: a multicentre study.

PubMed

Moreira, Luciana; Bins, Helena; Toressan, Ricardo; Ferro, Cláudia; Harttmann, Thiago; Petribú, Kátia; Juruena, Mário Francisco; do Rosário, Maria Conceição; Ferrão, Ygor Arzeno

2013-04-01

In women with obsessive-compulsive disorder (OCD), symptom severity appears to fluctuate over the course of the menstrual cycle. The objective of this paper was to compare female OCD patients with and without premenstrual worsening of obsessive-compulsive symptoms (OCS), in terms of the clinical characteristics of OCD. This was a cross-sectional study involving 455 women with OCD, of whom 226 (49.7%) had experienced premenstrual OCS worsening and 229 (50.3%) had not (PMOCS-worse and PMOCS-same groups, respectively). Data were collected with the original and dimensional versions of the Yale-Brown obsessive-compulsive scale, as well as with the Beck Depression Inventory (BDI) and Beck anxiety inventory (BAI). We found significant differences between the PMOCS-same and PMOCS-worse groups, the latter showing a higher frequency of suicidal ideation (P<.001), suicide attempts (P=.027), current use of selective serotonin reuptake inhibitors (P=.022), lifetime use of mood stabilisers (P=.015), and sexual/religious obsessions (P<.001; OR=1.90), as well as higher scores on the BDI (P<.001) and BAI (P<.001). Underscoring the fact that OCD is a heterogeneous disorder, there appears to be a subgroup of female OCD patients in whom the premenstrual period is associated with a higher frequency of sexual/religious obsessions, depression, anxiety, and suicidality. This might be attributable to hormonal fluctuations. Further studies are warranted in order to investigate this hypothesis by evaluating such patients at different phases of the menstrual cycle, as well as measuring hormonal levels. Copyright © 2012 Elsevier Inc. All rights reserved.

Race, gender, and language concordance in the primary care setting.

PubMed

Martin, Brian C; Shi, Leiyu; Ward, Ryan D

2009-01-01

The purpose of this paper is to examine race, gender and language concordance in terms of importance to primary care. The 2003 Medical Expenditure Panel Survey Household Component (MEPS) was used. Four distinguishing primary care attributes and selected measures were operationalized primarily from a sample subset that identified a usual source of care (USC): accessibility to USC; interface between primary care and specialist services; treatment decisions; and preventive services received from the USC. Bivariate and multivariate results are reported. Adjusting for covariates, the following items remained statistically significant: race--choosing primary care physician as USC, USC having office hours, and going to USC for new health problems; gender--choosing primary care physician as USC and USC having office hours; and language--lack of difficulty contacting the USC after hours. However, these items appear to be isolated cases rather than indicators that concordance plays a key role in determining primary care quality. Language barriers/communication issues are the only areas where improvement appears warranted. While the study has strong accessibility and interpersonal relationship measures, service coordination and comprehensiveness indicators are limited. The analyses' cross-sectional nature also poses a problem in drawing causal relationships and conclusive findings. Finally, sample size limitations preclude stratified analyses across racial/ethnic groups, an important consideration as the relationships between concordance and quality may vary across groups. This study indicates that more research is needed in this area to determine future resource allocation and policy direction. The unique contribution of the study is to suggest that race and gender concordance may not accurately predict primary health care quality.

Computational Analysis of Candidate Disease Genes and Variants for Salt-Sensitive Hypertension in Indigenous Southern Africans

PubMed Central

Tiffin, Nicki; Meintjes, Ayton; Ramesar, Rajkumar; Bajic, Vladimir B.; Rayner, Brian

2010-01-01

Multiple factors underlie susceptibility to essential hypertension, including a significant genetic and ethnic component, and environmental effects. Blood pressure response of hypertensive individuals to salt is heterogeneous, but salt sensitivity appears more prevalent in people of indigenous African origin. The underlying genetics of salt-sensitive hypertension, however, are poorly understood. In this study, computational methods including text- and data-mining have been used to select and prioritize candidate aetiological genes for salt-sensitive hypertension. Additionally, we have compared allele frequencies and copy number variation for single nucleotide polymorphisms in candidate genes between indigenous Southern African and Caucasian populations, with the aim of identifying candidate genes with significant variability between the population groups: identifying genetic variability between population groups can exploit ethnic differences in disease prevalence to aid with prioritisation of good candidate genes. Our top-ranking candidate genes include parathyroid hormone precursor (PTH) and type-1angiotensin II receptor (AGTR1). We propose that the candidate genes identified in this study warrant further investigation as potential aetiological genes for salt-sensitive hypertension. PMID:20886000

Male infertility in a private Kenyan hospital.

PubMed

Muthuuri, J M

2005-07-01

To study the incidence and aetiology of male infertility in Mombasa, Kenya. Retrospective study. The Mombasa Hospital Private Clinics, from January 1996 to 2001. Forty three men, aged between 21 and 55 years, referred to me with the chief complaint of infertility of unknown cause. Patients were managed conservatively and operatively. Histological and laboratory evaluations. Of the 43 patients observed, ten (23%) presented with signs of hypogonadism, fifteen (35%) with signs of acute and sub-acute inflammatory process (pain and swelling), four (9%) and prolactinaemia, two (5%) had signs of gonadotropin insufficiency and another two (5%) patients had varicocoeles. We did not establish the cause in ten (23%) patients. Male infertility in Mombasa appears to be primarily due to hypogonadism (23%), although in an equal proportion the cause is not obvious (idiopathic). A significant number of the infertility cases can be attributed to easily treatable conditions such as infections and infestations (16%). The sample available is however not big enough to warrant any major conclusions as to the overall male infertility status in establishing possible avenues for future research.

Traffic Accidents—Chronic Medical Conditions as a Cause

PubMed Central

Waller, Julian A.

1966-01-01

From comparatively scanty information, an increased traffic accident risk appears to be associated with several chronic medical conditions including alcoholism, cardiovascular disease, epilepsy, diabetes and mental illness. Further study probably will show that medical handicaps other than alcoholism are a factor in from 5 to 10 per cent of traffic accidents. However, in about half of the accidents caused by heart attacks, the individual has no previous knowledge of his illness, and prevention of the accident would not be possible. A selective program for identifying high risk drivers with medical conditions is feasible and warranted, but a program of mass medical examinations for all drivers is not. A very strong relationship has been shown between drunk driving and traffic accidents, and 50 to 75 per cent of all severe and fatal traffic accidents involve the use of alcohol. However, studies have shown that drivers with alcoholism rather than social drinkers represent the preponderance, but not the entirety, of those who get into trouble. A major reduction in the traffic accident toll may thus depend on the early identification and treatment of alcoholism. PMID:18730024

An initial reliability and validity study of the Interaction, Communication, and Literacy Skills Audit.

PubMed

El-Choueifati, Nisrine; Purcell, Alison; McCabe, Patricia; Heard, Robert; Munro, Natalie

2014-06-01

Early childhood educators (ECEs) have an important role in promoting positive outcomes for children's language and literacy development. This paper reports the development of a new tool, The Interaction Communication and Literacy (ICL) Skills Audit, and pilots its reliability and validity. Intra- and inter-rater reliability was examined by three speech-language pathologists (SLPs). Five skill areas relating to ECE language and literacy practice were rated. The face and content validity of the ICL Skills Audit was examined by expert SLPs (n = 8) and expert ECEs (n = 4) via questionnaire. The overall intra-rater reliability for the ICL Skills Audit was excellent with percentage close agreement (PCA) of 91-94. Inter-rater agreement was PCA 68-80. Expert SLPs and ECEs agreed that the content was comprehensive and practical. Based on this preliminary study, the ICL Skills Audit appears to be a promising tool that can be used by SLPs and ECEs in collaboration to measure the skills of ECEs in the areas of language and literacy support. Future psychometric and outcome research on the revised ICL Skills Audit is warranted.

Symptom dimensions in obsessive-compulsive disorder: phenomenology and treatment outcomes with exposure and ritual prevention.

PubMed

Williams, Monnica T; Mugno, Beth; Franklin, Martin; Faber, Sonya

2013-01-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. Copyright © 2013 S. Karger AG, Basel.

Potential Mechanisms of Cancer Prevention by Weight Control

NASA Astrophysics Data System (ADS)

Jiang, Yu; Wang, Weiqun

Weight control via dietary caloric restriction and/or physical activity has been demonstrated in animal models for cancer prevention. However, the underlying mechanisms are not fully understood. Body weight loss due to negative energy balance significantly reduces some metabolic growth factors and endocrinal hormones such as IGF-1, leptin, and adiponectin, but enhances glucocorticoids, that may be associated with anti-cancer mechanisms. In this review, we summarized the recent studies related to weight control and growth factors. The potential molecular targets focused on those growth factors- and hormones-dependent cellular signaling pathways are further discussed. It appears that multiple factors and multiple signaling cascades, especially for Ras-MAPK-proliferation and PI3K-Akt-anti-apoptosis, could be involved in response to weight change by dietary calorie restriction and/or exercise training. Considering prevalence of obesity or overweight that becomes apparent over the world, understanding the underlying mechanisms among weight control, endocrine change and cancer risk is critically important. Future studies using "-omics" technologies will be warrant for a broader and deeper mechanistic information regarding cancer prevention by weight control.

An Aqueous Extract of Marine Microalgae Exhibits Antimetastatic Activity through Preferential Killing of Suspended Cancer Cells and Anticolony Forming Activity

PubMed Central

Somasekharan, Syam Prakash; El-Naggar, Amal; Sorensen, Poul H.

2016-01-01

Research on marine natural products as potential anticancer agents is still limited. In the present study, an aqueous extract of a Canadian marine microalgal preparation was assessed for anticancer activities using various assays and cell lines of human cancers, including lung, prostate, stomach, breast, and pancreatic cancers, as well as an osteosarcoma. In vitro, the microalgal extract exhibited marked anticolony forming activity. In addition, it was more toxic, as indicated by increased apoptosis, to nonadherent cells (grown in suspension) than to adherent cells. In vivo, an antimetastatic effect of the extract was observed in NOD-SCID mice carrying subrenal capsule xenografts of PC3 prostate cancer cells. The results of the present study suggest that the antimetastatic effect of the aqueous microalgal extract is based on inhibition of colony forming ability of cancer cells and the preferential killing of suspended cancer cells. Further research aimed at identification of the molecular basis of the anticancer activities of the microalgal extract appears to be warranted. PMID:27656243

Severe and acute complications of biologics in psoriasis.

PubMed

Oussedik, Elias; Patel, Nupur U; Cash, Devin R; Gupta, Angela S; Feldman, Steven R

2017-12-01

Biologic therapies have revolutionized the approach to immune-mediated diseases such as psoriasis. Due to their favorable safety profiles and excellent efficacy, biologic agents are considered the gold standard for moderate-to-severe psoriasis. The aim of this paper is to saliently review the severe and acute complications of the Food and Drug Administration (FDA) approved biologic agents for psoriasis. Reviewed agents include tumor necrosis factor alpha inhibitors (etanercept, infliximab, and adalimumab), interleukin 12/23 inhibitors (ustekinumab), and interleukin 17 (IL-17) inhibitors (secukinumab and ixekizumab). While malignancies, serious infections, and major adverse cardiovascular events have been reported, their association with biologic therapy are not hypothesized as causal. However, IL-17 inhibitors appear to cause exacerbations and new cases of inflammatory bowel disease. While more long-term studies are warranted in understanding the biologic's long-term side effect profile, short-term studies have confirmed that the biologics are some of the safest treatment options for psoriasis. Nevertheless, certain populations yield higher risk to acute complications with the biologics than others - physicians must use their judgement and vigilance when monitoring and treating patients undergoing therapy with biological agents.

Identification and Evolutionary Analysis of Potential Candidate Genes in a Human Eating Disorder.

PubMed

Sabbagh, Ubadah; Mullegama, Saman; Wyckoff, Gerald J

2016-01-01

The purpose of this study was to find genes linked with eating disorders and associated with both metabolic and neural systems. Our operating hypothesis was that there are genetic factors underlying some eating disorders resting in both those pathways. Specifically, we are interested in disorders that may rest in both sleep and metabolic function, generally called Night Eating Syndrome (NES). A meta-analysis of the Gene Expression Omnibus targeting the mammalian nervous system, sleep, and obesity studies was performed, yielding numerous genes of interest. Through a text-based analysis of the results, a number of potential candidate genes were identified. VGF, in particular, appeared to be relevant both to obesity and, broadly, to brain or neural development. VGF is a highly connected protein that interacts with numerous targets via proteolytically digested peptides. We examined VGF from an evolutionary perspective to determine whether other available evidence supported a role for the gene in human disease. We conclude that some of the already identified variants in VGF from human polymorphism studies may contribute to eating disorders and obesity. Our data suggest that there is enough evidence to warrant eGWAS and GWAS analysis of these genes in NES patients in a case-control study.

The proboscis extension reflex to evaluate learning and memory in honeybees ( Apis mellifera): some caveats

NASA Astrophysics Data System (ADS)

Frost, Elisabeth H.; Shutler, Dave; Hillier, Neil Kirk

2012-09-01

The proboscis extension reflex (PER) is widely used in a classical conditioning (Pavlovian) context to evaluate learning and memory of a variety of insect species. The literature is particularly prodigious for honeybees ( Apis mellifera) with more than a thousand publications. Imagination appears to be the only limit to the types of challenges to which researchers subject honeybees, including all the sensory modalities and a broad diversity of environmental treatments. Accordingly, some remarkable insights have been achieved using PER. However, there are several challenges to evaluating the PER literature that warrant a careful and thorough review. We assess here variation in methods that makes interpretation of studies, even those researching the same question, tenuous. We suggest that the numerous variables that might influence experimental outcomes from PER be thoroughly detailed by researchers. Moreover, the influence of individual variables on results needs to carefully evaluated, as well as among two or more variables. Our intent is to encourage investigation of the influence of numerous variables on PER results.

Perfectionism dimensions and dependency in relation to personality vulnerability and psychosocial adjustment in patients with coronary artery disease.

PubMed

Dunkley, David M; Schwartzman, Deborah; Looper, Karl J; Sigal, John J; Pierre, Andrena; Kotowycz, Mark A

2012-06-01

The present study sought to illuminate self-criticism and personal standards dimensions of perfectionism and dependency as specific cognitive-personality vulnerability factors that might contribute to a better understanding of numerous psychosocial problem areas that are relevant to coronary artery disease (CAD). One hundred and twenty-three patients diagnosed with clinically significant CAD completed self-report questionnaires. Zero-order correlations and factor analysis results revealed that self-criticism was primarily related to personality vulnerability (aggression/anger/hostility, Type D negative affectivity) and psychosocial maladjustment (depressive symptoms, worry, avoidant coping, support dissatisfaction), whereas personal standards was primarily related to adaptive coping (problem-focused coping, positive reinterpretation) and dependency was primarily related to worry. Hierarchical regression results demonstrated the incremental utility of self-criticism, personal standards, and dependency in relation to (mal)adjustment over and above aggression/anger/hostility, negative affectivity, and social inhibition. Continued efforts to understand the role of perfectionism dimensions and dependency in CAD appear warranted.

Modulation of corneal wound healing after excimer laser keratomileusis using topical mitomycin C and steroids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Talamo, J.H.; Gollamudi, S.; Green, W.R.

1991-08-01

A 193-nm excimer laser system was used to create deep stromal ablations in seven New Zealand white rabbits and shallow ablations in three. Eyes were randomized for treatment with topical mitomycin C, steroids, and erythromycin; topical steroids and erythromycin; or topical erythromycin only. All treatment regimens were instituted twice daily for 14 days. All eyes reepithelialized normally within 3 to 5 days. During 10 weeks of follow-up, all eyes developed moderate reticular subepithelial haze without significant differences among treatment groups. Results of light, fluorescence, and electron microscopic examination showed anterior stromal scarring and markedly reduced new subepithelial collagen formation inmore » the group treated with mitomycin C, corticosteroids, and erythromycin. Focal abnormalities of Descemet's membrane and endothelial abnormalities were present in all treatment groups. Combination therapy with topical steroids, mitomycin C, and erythromycin to control the corneal wound healing response after refractive laser surgery appears promising and warrants further study.« less

Do spouses coordinate their work exits? A combined survey and register analysis from Norway.

PubMed

Syse, Astri; Solem, Per Erik; Ugreninov, Elisabeth; Mykletun, Reidar; Furunes, Trude

2014-09-01

Research on spouses' joint work exits is scarce, although household factors such as spouses' work status, marital quality, and caregiving burdens are likely to affect seniors' work engagement. We therefore examine whether the work exit probability of one spouse affects that of the other. Discrete-time hazard regression analyses of survey data linked to later registry information including all gainfully employed married respondents aged 50-74 with a working spouse (N = 1,764) were used to assess subsequent work exits. A spouse's work exit is a strong predictor of a respondent's work exit (hazard ratio 3.1, 95% confidence interval [2.5, 4.0]). Educational attainment, poor marital quality, and spouses' health and care needs do not predict work exits. Surprisingly, no gender differences are observed. Research on larger survey samples to distinguish different work exit routes and reasons for spouses' joint work exits appears warranted. To account for cultural and welfare state characteristics, cross-national studies ought to be undertaken. © The Author(s) 2013.

Self-esteem, Self-focused Attention, and the Mediating Role of Fear of Negative Evaluation in College Students With and Without Asthma.

PubMed

Junghans-Rutelonis, Ashley N; Suorsa, Kristina I; Tackett, Alayna P; Burkley, Edward; Chaney, John M; Mullins, Larry L

2015-01-01

The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population. Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of self-esteem regarding participation in social activities among college students appears warranted.

Absorption atelectasis: incidence and clinical implications.

PubMed

O'Brien, Jennifer

2013-06-01

General anesthesia is known to cause pulmonary atelectasis; in turn, atelectasis increases shunt, decreases compliance, and may lead to perioperative hypoxemia. One mechanism for the formation of atelectasis intraoperatively is ventilation with 100% oxygen. The goal of this review is to determine if research suggests that intraoperative ventilation with 100% oxygen leads to clinically significant pulmonary side effects. An initial literature search included electronic databases (Cumulative Index to Nursing & Allied Health Literature [CINAHL], PubMed, MEDLINE, Embase, and The GeneraCochrane Library) using the following search terms: oxygen (administration and dosage), atelectasis, pulmonary complications, and anesthesia. Results were limited to research studies, human subjects, and English-language publications between 1965 and 2011. From this body of research, it appears that absorption atelectasis does occur in healthy anesthetized adults breathing 100% oxygen. Data reviewed suggest that absorption atelectasis does not have significant clinical implications in healthy adults. However, further research is warranted in populations at increased risk of postoperative hypoxemia, including obese or elderly patients and those with preexisting cardiopulmonary disease.

Pathophysiology of constipation in the older adult

PubMed Central

McCrea, G Lindsay; Miaskowski, Christine; Stotts, Nancy A; Macera, Liz; Varma, Madhulika G

2008-01-01

This review provides information on the definition of constipation, normal continence and defecation and a description of the pathophysiologic mechanisms of constipation. In addition, changes in the anatomy and physiology of the lower gastrointestinal tract associated with aging that may contribute to constipation are described. MEDLINE (1966-2007) and CINAHL (1980-2007) were searched. The following MeSH terms were used: constipation/etiology OR constipation/physiology OR constipation/physiopathology) AND (age factors OR aged OR older OR 80 and over OR middle age). Constipation is not well defined in the literature. While self-reported constipation increases with age, findings from a limited number of clinical studies that utilized objective measures do not support this association. Dysmotility and pelvic floor dysfunction are important mechanisms associated with constipation. Changes in GI function associated with aging appear to be relatively subtle based on a limited amount of conflicting data. Additional research is warranted on the effects of aging on GI function, as well as on the timing of these changes. PMID:18461648

Fermentation of polysaccharides by Klebsiella and other facultative bacilli

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ochuba, G.U.; Von Riesen, V.L.

1980-05-01

Fermentations of 10 polysaccharides by species of the family Enterobacteriaceae were examined. Algin, guar, karaya, xanthan, and xylan were not fermented by any of the strains tested. Most of the activity was found in the tribe Klebsielleae. Klebseilla oxytoca fermented amylopectin (97% of the strains studied), carrageenan (100%), inulin (68%), polypectate (100%), and tragacanth (100%). Klebsiella pneumoniae fermented amylopectin (91%), carrageenan (100%), and tragacanth (86%). Carraggeenan was also fermented by Enterobacter aerogenes (100%), Enterobacter agglomerans (63%), Enterobacter cloacae (95%), and pectobacterium (38%). pectobacterium shared polypectate fermentation (100%) with K. oxytoca. With one exception, Serratia strains were negative on all polysaccharides.more » These results, along with other evidence, indicate that (i) the genus Klebsiella is biochemically the most versatile genus of the tribe, (ii) because of its distinct characteristics, K. oxytoca warrants species designation separate from K. pneumoniae, and (iii) some food additives generally considered indigestible can be metabolized by a few species of facultative bacilli, whereas others appear to be resistant.« less

Feasibility study of a game integrating assessment and therapy of tinnitus.

PubMed

Wise, K; Kobayashi, K; Searchfield, G D

2015-07-15

Tinnitus, head and ear noise, is due to maladaptive plastic changes in auditory and associated neural networks. Tinnitus has been traditionally managed through the use of sound to passively mask or facilitate habituation to tinnitus, a process that may take 6-12 months. A game-based perceptual training method, requiring localisation and selective attention to sounds, was developed and customised to the individual's tinnitus perception. Eight participants tested the games usability at home. Each participant successfully completed 30 min of training, for 20 days, along with daily psychoacoustic assessment of tinnitus pitch and loudness. The training period and intensity of training appears sufficient to reduce tinnitus handicap. The training approach used may be a viable alternative to frequency discrimination based training for treating tinnitus (Hoare et al., 2014) and a useful tool in exploring learning mechanisms in the auditory system. Integration of tinnitus assessment with therapy in a game is feasible, and the method(s) warrant further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

Neural mechanism of electroacupuncture's hypotensive effects

PubMed Central

Li, Peng; Longhurst, John C.

2010-01-01

EA at P 5–6 and S 36–37 using low current and low frequency may be able to reduce elevated blood pressure in a subset of patients (~70%) with mild to moderate hypertension. The effect is slow in onset but is long-lasting. Experimental studies have shown that EA inhibition of cardiovascular sympathetic neurons that have been activated through visceral reflex stimulation is through activation of neurons in the arcuate nucleus of the hypothalamus, vlPAG in the midbrain and NRP in the medulla, which, in turn, inhibit the activity of premotor sympathetic neurons in the rVLM. The arcuate also provides direct projections to the rVLM that contain endorphins. Glutamate, acetylcholine, opioids, GABA, nociceptin, serotonin and endocannabinoids all appear to participate in the EA hypotensive response although their importance varies between nuclei. Thus, a number of mechanisms underlying the long-lasting effect of EA on cardiovascular function have been identified but clearly further investigation is warranted. PMID:20444652

Perceptions of sexual coercion among young women in Uganda.

PubMed

Hayer, Manvir Kaur

2010-01-01

This paper sets out to explore Ugandan young women's definitions and perceptions of sexual coercion. A qualitative study was conducted with seven young women in rural Uganda. Participants filmed videos, wrote stories, made drawings and participated in transect walks before analysing their data through formal and informal discussions. Forced sex is defined narrowly to mean only rape. Verbal forms of sexual coercion were recognised, but only after some discussion. Verbal coercion is referred to as "abusing" or "convincing". Young women are commonly pressured into consenting to have sex, despite what they really want, owing to the socio-cultural circumstances. Young women in Uganda are significantly tolerant of sexual coercion. This tolerance appears to arise from power differentials between genders, and the socio-cultural environment shaping their lives. The paper improves understanding of young women's definitions and perceptions of sexual coercion, which is essential to provide effective violence prevention programmes. It also suggests that further research is warranted in this field.

Possible influence of infrasound on glioma cell response to chemotherapy: a pilot study.

PubMed

Yount, Garret; Taft, Ryan; West, Jeremy; Moore, Dan

2004-04-01

To assess the response of cultured human tumor cells to infrasound in combination with conventional anticancer agents using an infrasound-emitting apparatus marketed as a therapeutic device. Two pilot experiments measured proliferation of cultured brain tumor cells exposed to three treatment conditions: infrasound emission alone, infrasound in combination with the chemotherapy 5-fluorouracil (5-FU), and infrasound in combination with ionizing radiation. Results from each experimental condition were compared to those from appropriate control conditions. A standard colony-forming efficiency assay was used to assess tumor cell proliferation. Tumor cell proliferation was not significantly altered by treatment with infrasound alone, nor did infrasound appear to influence cellular response to x-rays. There was a significant interaction between 5-FU and infrasound (P < 0.0001), however, evident in decreased colony formation. Further research is warranted to assess potential synergism between infrasound and 5-FU against tumor cell proliferation, and to investigate the possible therapeutic use of infrasound.

Clinical evaluation of a novel microneedle device for intradermal delivery of an influenza vaccine: are all delivery methods the same?

PubMed

Levin, Yotam; Kochba, Efrat; Kenney, Richard

2014-07-23

The skin provides the largest immune barrier to infection and is a readily accessible site for vaccination, although intradermal (ID) injection can be challenging. The MicronJet™ microneedle is a novel device that consistently injects antigens very close to the skin's dendritic cells. A dose-sparing ID injection study was conducted in 280 healthy adult volunteers using trivalent virosomal adjuvanted influenza vaccine. ID injection of 3 μg using the MicronJet™ was well tolerated and showed a statistically higher geometric mean fold rise than the same dose ID using a conventional needle (Mantoux technique) for the H1N1 and B strains or a 15 μg intramuscular (IM) injection for the H3N2 strain. Thus, the immune response appears to partially depend on the delivery device and route of injection. The MicronJet™ may allow dose-sparing, yet give a superior response in influenza vaccination and warrants further clinical evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

The role of self-improvement and self-evaluation motives in social comparisons with idealised female bodies in the media.

PubMed

Halliwell, Emma; Dittmar, Helga

2005-09-01

This study investigates the effect of social comparisons with media models on women's body image based on either self-evaluation or self-improvement motives. Ninety-eight women, for whom appearance was a relevant comparison dimension, viewed advertisements that did, or did not, feature idealised models, after being prompted to engage in self-evaluation or self-improvement comparisons. The results indicate that, when focusing on self-evaluation, comparisons with thin models are associated with higher body-focused anxiety than viewing no model advertisements. In contrast, when focusing on self-improvement, comparisons with thin models are not associated with higher body-focused anxiety than viewing no models. Furthermore, women's general tendency to engage in social comparisons moderated the effects of self-evaluative comparisons with models, so that women who did not habitually engage in social comparisons were most strongly affected. It is suggested that motive for social comparison may explain previous inconsistencies in the experimental exposure literature and warrants more careful attention in future research.

WARRANT OFFICER AND CIVILIAN HOUSING, QUARTERS L FRONT ELEVATION. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

WARRANT OFFICER AND CIVILIAN HOUSING, QUARTERS L FRONT ELEVATION. - Naval Magazine Lualualei, Headquarters Branch, Warrant Officer's & Civilians Quarters Type, Along Sixty-sixth Street between Amberjack & Constitution Streets, Pearl City, Honolulu County, HI

Pilot trial of a dissonance-based cognitive-behavioral group depression prevention with college students.

PubMed

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M

2016-07-01

Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = 0.64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pilot Trial of a Dissonance-Based Cognitive-Behavioral Group Depression Prevention with College Students

PubMed Central

Rohde, Paul; Stice, Eric; Shaw, Heather; Gau, Jeff M.

2016-01-01

Objective Conduct a pilot trial testing whether a new cognitive-behavioral (CB) group prevention program that incorporated cognitive-dissonance change principles was feasible and appeared effective in reducing depressive symptoms and major depressive disorder onset relative to a brochure control condition in college students with elevated depressive symptoms. Method 59 college students (M age = 21.8, SD = 2.3; 68% female, 70% White) were randomized to the 6-session Change Ahead group or educational brochure control condition, completing assessments at pretest, posttest, and 3-month follow-up. Results Recruitment and screening methods were effective and intervention attendance was high (86% attended all 6 sessions). Change Ahead participants showed medium-large reductions in depressive symptoms at posttest (M d = .64), though the effect attenuated by 3-month follow-up. Incidence of major depression onset at 3-month follow-up was 4% for Change Ahead participants versus 13% (difference ns). Conclusions Change Ahead appears highly feasible and showed positive indications of reduced acute phase depressive symptoms and MDD onset relative to a minimal intervention control in this initial pilot. Given the brevity of the intervention, its apparent feasibility, and the lack of evidence-based depression prevention programs for college students, continued evaluation of Change Ahead appears warranted. PMID:27176493

Time Trends of Persistent Organic Pollutants in Benthic and Pelagic Indicator Fishes from Puget Sound, Washington, USA.

PubMed

West, James E; O'Neill, Sandra M; Ylitalo, Gina M

2017-08-01

We modeled temporal trends in polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and dichlorodiphenyltrichloroethane and its metabolites (DDTs) in two indicator fish species representing benthic and pelagic habitats in Puget Sound, Washington, USA. English sole (Parophrys vetulus, benthic) index sites and larger-scale Pacific herring (Clupea pallasii, pelagic) foraging areas represented a wide range of possible contamination conditions, with sampling locations situated adjacent to watersheds exhibiting high, medium and low development. Consistency in analytical data throughout the study was maintained by either calculating method-bias-correction factors on paired samples as methods evolved or by analyzing older archived samples by current methods. PCBs declined moderately in two herring stocks from a low-development basin (2.3 and 4.0% annual rate of decline) and showed no change in the highly developed and moderately developed basins during a 16- to 21-year period. PCBs increased in English sole from four of ten sites (2.9-7.1%), and the remaining six exhibited no significant change. PBDEs and DDTs declined significantly in all herring stocks (4.2-8.1%), although analytical challenges warrant caution in interpreting DDT results. PBDEs declined in English sole from two high-development and one low-development site (3.7-7.2%) and remained unchanged in the remaining seven. DDTs increased in English sole from one high-development site (Tacoma City Waterway) and declined in two high-development and one low development site. As with herring, analytical challenges warrant caution in interpreting the English sole DDT results. It is likely that source controls and mitigation efforts have contributed to the declines in PBDEs and DDTs overall, whereas PCBs appear to have persisted, especially in the pelagic food web, despite bans in PCB production and use.

Age, arterial stiffness, and components of blood pressure in Chinese adults.

PubMed

Zheng, Meili; Xu, Xiping; Wang, Xiaobin; Huo, Yong; Xu, Xin; Qin, Xianhui; Tang, Genfu; Xing, Houxun; Fan, Fangfang; Cui, Wei; Yang, Xinchun

2014-12-01

Blood pressure (BP) changes with age. We conducted a cross-sectional study in rural Chinese adults to investigate: (1) what is the relationship between age, arterial stiffness, and BP in Chinese men and women; and (2) to what degree can the age-BP relationship be explained by arterial stiffness, controlling for other covariables. These analyses included a total of 1688 subjects (males/females: 623/1065), aged 40 to 88 years. Among them, 353 (20.9%) had hypertension (defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg). Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). baPWV appeared to be more strongly correlated with BP (including SBP, DBP, mean arterial pressure [MAP], pulse pressure [PP]) than age (P < 0.001 for comparisons between Spearman correlation coefficients). Furthermore, baPWV was associated with BP (including SBP, DBP, MAP, and PP) and risk of hypertension in a dose-response fashion, independent of age; in contrast, the age-BP associations were either attenuated or became negative after adjusting for baPWV. Arterial stiffness appears to be an independent contributor to hypertension, even after adjusting for age and other covariables. In contrast, age-BP associations became attenuated or negative after adjusting for baPWV. The utility of baPWV as a diagnostic, prognostic, and therapeutic indicator for hypertension warrants further investigation.

Warrants for pedestrian over and underpasses

DOT National Transportation Integrated Search

1984-07-01

The purpose of this research was to develop warrants for pedestrian over and underpasses or grade separated pedestrian crossings (GSPCs). Currently there are no established nationally acceptable warrants to serve as standards in deciding whether or n...

I care, even after the first impression: Facial appearance-based evaluations in healthcare context.

PubMed

Mattarozzi, Katia; Colonnello, Valentina; De Gioia, Francesco; Todorov, Alexander

2017-06-01

Prior research has demonstrated that healthcare providers' implicit biases may contribute to healthcare disparities. Independent research in social psychology indicates that facial appearance-based evaluations affect social behavior in a variety of domains, influencing political, legal, and economic decisions. Whether and to what extent these evaluations influence approach behavior in healthcare contexts warrants research attention. Here we investigate the impact of facial appearance-based evaluations of trustworthiness on healthcare providers' caring inclination, and the moderating role of experience and information about the social identity of the faces. Novice and expert nurses rated their inclination to provide care when viewing photos of trustworthy-, neutral-, and untrustworthy-looking faces. To explore whether information about the target of care influences caring inclination, some participants were told that they would view patients' faces while others received no information about the faces. Both novice and expert nurses had higher caring inclination scores for trustworthy-than for untrustworthy-looking faces; however, experts had higher scores than novices for untrustworthy-looking faces. Regardless of a face's trustworthiness level, experts had higher caring inclination scores for patients than for unidentified individuals, while novices showed no differences. Facial appearance-based inferences can bias caring inclination in healthcare contexts. However, expert healthcare providers are less biased by these inferences and more sensitive to information about the target of care. These findings highlight the importance of promoting novice healthcare professionals' awareness of first impression biases. Copyright © 2017 Elsevier Ltd. All rights reserved.

WARRANT OFFICER AND CIVILIAN HOUSING, QUARTERS L FRONT ELEVATION W/POLE. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

WARRANT OFFICER AND CIVILIAN HOUSING, QUARTERS L FRONT ELEVATION W/POLE. - Naval Magazine Lualualei, Headquarters Branch, Warrant Officer's & Civilians Quarters Type, Along Sixty-sixth Street between Amberjack & Constitution Streets, Pearl City, Honolulu County, HI

Nutritional and Safety Outcomes from an Open-Label Micronutrient Intervention for Pediatric Bipolar Spectrum Disorders

PubMed Central

Gracious, Barbara; Arnold, L. Eugene; Failla, Mark; Chitchumroonchokchai, Chureeporn; Habash, Diane; Fristad, Mary A.

2013-01-01

Abstract Objective The purpose of this study was to report the safety, tolerability, and serum micronutrient concentrations and their correlations with mood changes from an 8 week pilot feasibility study of a 36 ingredient multinutrient supplement, EMPowerplus (EMP+), for pediatric bipolar spectrum disorders (BPSD). Methods Ten children ages 6–12 received EMP+ escalating from one to four capsules t.i.d., with four children increased to the maximum suggested dose, five capsules t.i.d. Outcome measures were micronutrient concentrations in serum and red blood cells, vital signs, body mass index (BMI), dietary intake (Food Frequency Questionnaire and 24 hour dietary recall interview), and mood and global functioning ratings. Results Seven children (70%) completed the study. Three (30%) terminated early for tolerability and compliance issues. Adverse effects were mild and transient, and chiefly consisted of initial insomnia or gastrointestinal (GI) upset. No differences occurred in BMI (p=0.310) or waist–hip ratio (WHR; p=0.674) pre- to postsupplementation. Four of the tested serum vitamin concentrations increased from pre- to postsupplementation: vitamin A-retinol, vitamin B6, vitamin E-α-tocopherol; and folate (all p<0.05). The increase in serum 25-OH vitamin D approached significance (p=0.063). No differences were found in dietary intake pre- to postsupplementation, suggesting that blood nutrient level increases were caused by EMP+. Conclusions In this open prospective study, short-term use of EMP+ in children with BPSD appeared safe and well-tolerated, with a side effect profile preferable to first-line psychotropic drugs for pediatric bipolar spectrum disorders. A double-blind, randomized clinical trial is feasible, appears safe, and is warranted by open-label clinical outcomes and plausible mechanisms of action, combined with documentation of increased serum concentrations of specific micronutrients. PMID:24138009

High fat diet induced atherosclerosis is accompanied with low colonic bacterial diversity and altered abundances that correlates with plaque size, plasma A-FABP and cholesterol: a pilot study of high fat diet and its intervention with Lactobacillus rhamnosus GG (LGG) or telmisartan in ApoE-/- mice.

PubMed

Chan, Yee Kwan; Brar, Manreetpal Singh; Kirjavainen, Pirkka V; Chen, Yan; Peng, Jiao; Li, Daxu; Leung, Frederick Chi-Ching; El-Nezami, Hani

2016-11-08

Atherosclerosis appears to have multifactorial causes - microbial component like lipopolysaccharides (LPS) and other pathogen associated molecular patterns may be plausible factors. The gut microbiota is an ample source of such stimulants, and its dependent metabolites and altered gut metagenome has been an established link to atherosclerosis. In this exploratory pilot study, we aimed to elucidate whether microbial intervention with probiotics L. rhamnosus GG (LGG) or pharmaceuticals telmisartan (TLM) could improve atherosclerosis in a gut microbiota associated manner. Atherosclerotic phenotype was established by 12 weeks feeding of high fat (HF) diet as opposed to normal chow diet (ND) in apolipoprotein E knockout (ApoE -/- ) mice. LGG or TLM supplementation to HF diet was studied. Both LGG and TLM significantly reduced atherosclerotic plaque size and improved various biomarkers including endotoxin to different extents. Colonial microbiota analysis revealed that TLM restored HF diet induced increase in Firmicutes/Bacteroidetes ratio and decrease in alpha diversity; and led to a more distinct microbial clustering closer to ND in PCoA plot. Eubacteria, Anaeroplasma, Roseburia, Oscillospira and Dehalobacteria appeared to be protective against atherosclerosis and showed significant negative correlation with atherosclerotic plaque size and plasma adipocyte - fatty acid binding protein (A-FABP) and cholesterol. LGG and TLM improved atherosclerosis with TLM having a more distinct alteration in the colonic gut microbiota. Altered bacteria genera and reduced alpha diversity had significant correlations to atherosclerotic plaque size, plasma A-FABP and cholesterol. Future studies on such bacterial functional influence in lipid metabolism will be warranted.

Effects of cellulite treatment with RF, IR light, mechanical massage and suction treating one buttock with the contralateral as a control.

PubMed

Romero, Carmen; Caballero, Natalia; Herrero, Montse; Ruíz, Raquel; Sadick, Neil S; Trelles, Mario A

2008-12-01

A system that combines bipolar radio frequency (RF) and intense infrared light (IR) together with mechanical massage and suction has recently been reported as being efficient for cellulite treatment. The present split study was designed to evaluate the efficacy of such a system through various treatments of cellulite located on the buttocks. Ten patients were enrolled for 12 sessions of 30 minutes each performed over one buttock, the other buttock serving as an untreated control. Sessions were conducted twice a week for a period of 12 weeks. Clinical photography and profilometry were carried out to assess textural changes before (baseline) and 2 months after the final treatment. Histopathology was performed at baseline, 2 hours after the first session, and just before the 12th session and 2 months thereafter. All patients noted improvement in the treated buttock before the final session, which was maintained at the 2-month assessment. Improved skin appearance was noticed after the first session and was maintained throughout the study. All patients were satisfied with the results and requested further treatment in order to balance the results in both buttocks. Random histological analyses suggested dermal firmness, fibre compaction and tightening of skin layers, including the subcutis, as possible reasons for the effects achieved. The authors recognize that the small number of participants limits the statistical power of the study. Treatment sessions with the combined RF, IR light and mechanical massage and suction system were complication free, produced improvements in the overall cellulite appearance and skin condition, suggesting that further treatment sessions for maintenance could sustain patient satisfaction index (SI) and lead to lasting results. Based on the good results in the limited trial population, further studies with larger patient populations are warranted.

The posterior parietal paradox: Why do functional magnetic resonance imaging and lesion studies on episodic memory produce conflicting results?

PubMed

Schoo, L A; van Zandvoort, M J E; Biessels, G J; Kappelle, L J; Postma, A; de Haan, E H F

2011-03-01

Recent functional magnetic resonance imaging (fMRI) studies addressing healthy subjects point towards posterior parietal cortex (PPC) involvement in episodic memory tasks. This is noteworthy, since neuropsychological studies usually do not connect parietal lesions to episodic memory impairments. Therefore an inventory of the possible factors behind this apparent paradox is warranted. This review compared fMRI studies which demonstrated PPC activity in episodic memory tasks, with findings with studies of patients with PPC lesions. A systematic evaluation of possible explanations for the posterior parietal paradox indicates that PPC activation in fMRI studies does not appear to be attributable to confounding cognitive/psychomotor processes, such as button pressing or stimulus processing. What may be of more importance is the extent to which an episodic memory task loads on three closely related cognitive processes: effort and attention, self-related activity, and scene and image construction. We discuss to what extent these cognitive processes can account for the paradox between lesion and fMRI results. They are strongly intertwined with the episodic memory and may critically determine in how far the PPC plays a role in a given memory task. Future patient studies might profit from specifically taking these cognitive factors into consideration in the task design. ©2010 The British Psychological Society.

The cognitive treatment components and therapies of cognitive behavioral therapy for insomnia: A systematic review.

PubMed

Jansson-Fröjmark, Markus; Norell-Clarke, Annika

2018-06-07

Since the beginning of the twenty-first century, there has been an increased focus on developing and testing cognitive components and therapies for insomnia disorder. The aim of the current review was thus to describe and review the efficacy of cognitive components and therapies for insomnia. A systematic review was conducted on 32 studies (N = 1455 subjects) identified through database searches. Criteria for inclusion required that each study constituted a report of outcome from a cognitive component or therapy, that the study had a group protocol, adult participants with diagnosed insomnia or undiagnosed insomnia symptoms or reported poor sleep, and that the study was published until and including 2016 in English. Each study was systematically reviewed with a standard coding sheet. Several cognitive components, a multi-component cognitive program, and cognitive therapy were identified. It is concluded that there is support for paradoxical intention and cognitive therapy. There are also other cognitive interventions that appears promising, such as cognitive refocusing and behavioral experiments. For most interventions, the study quality was rated as low to moderate. We conclude that several cognitive treatment components and therapies can be viewed as efficacious or promising interventions for patients with insomnia disorder. Methodologically stronger studies are, however, warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

Insights gained through Marte Meo counselling: experiences of nurses in dementia specific care units.

PubMed

Einang Alnes, Rigmor; Kirkevold, Marit; Skovdahl, Kirsti

2011-06-01

This study sought to uncover what nurses perceived to have learned, during their participation in video supported counselling, based on Marte Meo principles, in four dementia specific care units. This was a descriptive qualitative study. Data were collected through 12 individual and four focus group interviews. In addition, supplementary data from two video recordings and one written log were included. Findings emerged through content analysis and re-examination of the text based on the initial analysis. The nurses experienced that they acquired new knowledge about the residents through Marte Meo Counselling (MMC), resulting in improved capability to interpret the residents` expressions, and increased awareness of the residents' competence. New knowledge about themselves as nurses also emerged; they recognised how their actions entailed consequences for the interaction, in turn making them conscious of the usefulness of taking time, pacing their interactions, maintaining eye contact and describing the situation in words when the interaction took place. This appeared to increase the resident's perception of being able to cope. This study indicates that MMC helped the nurses to gain knowledge about how to improve interactions with residents suffering from dementia. Further research is warranted into the effectiveness of MMC. © 2010 Blackwell Publishing Ltd.

Innovation to motivation--pilot study of a mobile phone intervention to increase physical activity among sedentary women.

PubMed

Fukuoka, Yoshimi; Vittinghoff, Eric; Jong, So Son; Haskell, William

2010-01-01

This uncontrolled pilot study assessed changes in pedometer-measured step counts and self-reported physical activity during a 3-week mobile phone-based intervention. We also explored whether age, BMI, and psychosocial factors were associated with changes in step counts. Forty-one sedentary adult women in San Francisco, California were asked to report their pedometer steps using a study-supplied mobile phone from June to September 2008. In the second and third weeks, daily prompts delivered by the mobile phone encouraged participants to increase steps by 20% from the previous week. Mean age was 48 years. Average daily total steps increased by approximately 800 or 15% over three weeks (p<0.001). Lower BMI, no antidepressant use, and lower self-reported health status were associated with higher step counts at baseline. Improvements in self-reported will-power were associated with increases in step counts (p<0.001). Neither age (p=0.55) nor BMI (p=0.13) was significantly associated with changes in activity over the 3 weeks. The intervention appeared to motivate sedentary women to increase their physical activity. A randomized controlled clinical trial is warranted and feasible. Copyright © 2010 Elsevier Inc. All rights reserved.

Endoscopic Management of Pancreatic Fluid Collections in Children.

PubMed

Nabi, Zaheer; Talukdar, Rupjyoti; Reddy, D Nageshwar

2017-07-15

The incidence of acute pancreatitis in children has increased over the last few decades. The development of pancreatic fluid collection is not uncommon after severe acute pancreatitis, although its natural course in children and adolescents is poorly understood. Asymptomatic fluid collections can be safely observed without any intervention. However, the presence of clinically significant symptoms warrants the drainage of these fluid collections. Endoscopic management of pancreatic fluid collection is safe and effective in adults. The use of endoscopic ultrasound (EUS)-guided procedure has improved the efficacy and safety of drainage of pancreatic fluid collections, which have not been well studied in pediatric populations, barring a scant volume of small case series. Excellent results of EUS-guided drainage in adult patients also need to be verified in children and adolescents. Endoprostheses used to drain pancreatic fluid collections include plastic and metal stents. Metal stents have wider lumens and become clogged less often than plastic stents. Fully covered metal stents specifically designed for pancreatic fluid collection are available, and initial studies have shown encouraging results in adult patients. The future of endoscopic management of pancreatic fluid collection in children appears promising. Prospective studies with larger sample sizes are required to establish their definitive role in the pediatric age group.

Vitamin E and essential polyunsaturated fatty acids supplementation in schizophrenia patients treated with haloperidol.

PubMed

Bošković, Marija; Vovk, Tomaž; Koprivšek, Jure; Plesničar, Blanka Kores; Grabnar, Iztok

2016-05-01

Previously, oxidative damage has been associated with severity of clinical symptoms and supplementation with antioxidants and essential polyunsaturated fatty acids (EPUFAs) was proposed to have beneficial effects in schizophrenia. We evaluated the effects of supplementation with EPUFAs and vitamin E in patients treated with haloperidol depot injection. This was a double-blind randomized placebo-controlled study with four arms (Placebo, vitamin E, EPUFAs, and vitamin E + EPUFAs). Biomarkers of oxidative stress, neurochemistry, psychopathology, and extrapyramidal symptoms were assessed at baseline and after 4 months. In EPUFAs group of patients, reduced glutathione concentration was increased compared to placebo. Concentration of oxidized glutathione was decreased in patients receiving vitamin E. In addition, compared to placebo a non-significant trend of increased activity of catalase and superoxide dismutase was observed in all three treatment groups. Patients receiving vitamin E experienced less motor retardation. No difference in extrapyramidal symptoms was found. Our study indicates that supplementation with vitamin E and EPUFAs may improve the antioxidative defense, especially glutathione system, while there is no major effect on symptoms severity. Supplemental treatment with EPUFAs and vitamin E in schizophrenia patients treated with haloperidol is potentially beneficial and a larger independent study appears warranted.

Considering sport participation as a source for physical activity among adolescents.

PubMed

Pharr, Jennifer; Lough, Nancy L

2014-07-01

Studies have shown participation in sport is lower among girls than boys, decreases as students matriculate through high school, is lowest among Black and Hispanic girls and has a positive relationship with SES. With sport recognized as a contributor to physical activity and health in adolescents, consideration of diminishing rates of participation appears warranted. The purpose of this study was to identify patterns related to differences in self-reported sport participation between genders, ethnic groups, grades and SES. This study was a cross-sectional, secondary analysis of data collected for a sport interest survey. All students in grades 8-11 attending middle and high schools were provided an opportunity to participate in the survey. Data from 49,832 students were analyzed. Among the participants, Black girls participated more and White girls participated less than expected. Black boys participated more while White and Asian boys participated less than expected. Reported sport participation was high compared with national data when analyzed by gender and ethnic group. Sport participation was higher in low SES schools compared with high SES schools. The importance of sport as a source of physical activity in underserved groups is significant.

Cannabis Use, Lung Cancer, and Related Issues.

PubMed

Jett, James; Stone, Emily; Warren, Graham; Cummings, K Michael

2018-04-01

The cannabis plant and its derivatives have been exploited for centuries for recreational and medicinal purposes, with millions of regular users around the world. The recreational use of cannabis is reflective of its neuropsychiatric effects, such as anxiolysis and euphoria. However, cannabis appears to have an emerging therapeutic role, especially in chronic disease and as an adjunct to cancer treatment. Increasing evidence supports cannabis in the management of chemotherapy-induced nausea and vomiting (CINV) and for pain management; however, studies are limited, particularly by difficulties associated with standardized dosing estimates and inability to accurately assess biologic activities of compounds in cannabis and derivative products. Smoking cannabis has not been proved to be a risk factor in the development of lung cancer, but the data are limited by small studies, misclassification due to self-reporting of use, small numbers of heavy cannabis smokers, and confounding of the risk associated with known causative agents for lung cancer (such as parallel chronic tobacco use). Cannabis and its biologically effective derivatives warrant additional research, ideally, controlled trials in which the cannabidiol and the delta-9-tetrahydrocabinol strength and use are controlled and documented. Copyright © 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Puzzle Pieces: Neural Structure and Function in Prader-Willi Syndrome

PubMed Central

Manning, Katherine E.; Holland, Anthony J.

2015-01-01

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder of genomic imprinting, presenting with a behavioural phenotype encompassing hyperphagia, intellectual disability, social and behavioural difficulties, and propensity to psychiatric illness. Research has tended to focus on the cognitive and behavioural investigation of these features, and, with the exception of eating behaviour, the neural physiology is currently less well understood. A systematic review was undertaken to explore findings relating to neural structure and function in PWS, using search terms designed to encompass all published articles concerning both in vivo and post-mortem studies of neural structure and function in PWS. This supported the general paucity of research in this area, with many articles reporting case studies and qualitative descriptions or focusing solely on the overeating behaviour, although a number of systematic investigations were also identified. Research to date implicates a combination of subcortical and higher order structures in PWS, including those involved in processing reward, motivation, affect and higher order cognitive functions, with both anatomical and functional investigations indicating abnormalities. It appears likely that PWS involves aberrant activity across distributed neural networks. The characterisation of neural structure and function warrants both replication and further systematic study. PMID:28943631

Puzzle Pieces: Neural Structure and Function in Prader-Willi Syndrome.

PubMed

Manning, Katherine E; Holland, Anthony J

2015-12-17

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder of genomic imprinting, presenting with a behavioural phenotype encompassing hyperphagia, intellectual disability, social and behavioural difficulties, and propensity to psychiatric illness. Research has tended to focus on the cognitive and behavioural investigation of these features, and, with the exception of eating behaviour, the neural physiology is currently less well understood. A systematic review was undertaken to explore findings relating to neural structure and function in PWS, using search terms designed to encompass all published articles concerning both in vivo and post-mortem studies of neural structure and function in PWS. This supported the general paucity of research in this area, with many articles reporting case studies and qualitative descriptions or focusing solely on the overeating behaviour, although a number of systematic investigations were also identified. Research to date implicates a combination of subcortical and higher order structures in PWS, including those involved in processing reward, motivation, affect and higher order cognitive functions, with both anatomical and functional investigations indicating abnormalities. It appears likely that PWS involves aberrant activity across distributed neural networks. The characterisation of neural structure and function warrants both replication and further systematic study.

Menstruation and suicide: a histopathological study.

PubMed

Leenaars, Antoon A; Dogra, T D; Girdhar, Shalini; Dattagupta, S; Leenaars, Lindsey

2009-01-01

Previous research, albeit limited, has reported mixed findings on the impact of menstruation cycle on suicidal behavior. The contribution of menstruation to completed suicide is also controversial; the studies are, in fact, very limited and are not carefully designed. To examine whether the menstruation cycle impacts on suicide. In order to explore this relationship, 56 autopsies on completed suicides in females were performed and matched to a control group of 44 females who had died from other causes, at the All India Institute of Medical Sciences in New Delhi. Histopathological examination, a method of collecting tissue from the uterus through biopsy, was used to determine the stage of the menstrual cycle. The results show that 25% of women who had died by suicide were menstruating at the time, compared to 4.5% of the control group; this is statistically (chi2) significant at the p < .002 level. Menstruation in the women who completed suicide, compared to a control group, appeared to have an association, though more research is warranted. Not only there are serious methodological problems in the study of menstruation and suicide (largely because of problematic tissue storage and examination), but also because of the need to understand the impact within a larger psychological, social, and cultural frame.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Royer, Michael P.; Houser, Kevin W.

An experiment was conducted to examine the effect of tuning optical radiation on brightness perception for younger (18-25 years of age) and older (50 years of age or older) observers. Participants made forced-choice evaluations of the brightness of a full factorial of stimulus pairs selected from two groups of four metameric stimuli. The large-field stimuli were created by systematically varying either the red or the blue primary of an RGB LED mixture. The results indicate that light stimuli of equal illuminance and chromaticity do not appear equally bright to either younger or older subjects. The rank-order of brightness is notmore » predicted by any current model of human vision or theory of brightness perception including Scotopic to Photopic or Cirtopic to Photopic ratio theory, prime color theory, correlated color temperature, V(λ)-based photometry, color quality metrics, linear brightness models, or color appearance models. Age may affect brightness perception when short-wavelength primaries are used, especially those with a peak wavelength shorter than 450 nm. The results suggest further development of metrics to predict brightness perception is warranted, and that including age as a variable in predictive models may be valuable.« less

Overshadowing: a silver lining to a dark cloud in horse training.

PubMed

McLean, Andrew N

2008-01-01

Overshadowing is a process known in behavioral science that occurs when two stimuli of different strengths are applied simultaneously to a nonhuman animal. Typically, the stronger stimulus overshadows the weaker one, resulting in attenuation of the weaker stimulus. This phenomenon explains ways in which the decreased responsiveness and consequent conflict behaviors (and possibly learned helplessness and wastage) in some performance horses can result from the application of two concurrent aversive stimuli. Despite some adverse consequences in the context of ridden horses, overshadowing can have serendipitous benefits because it offers an efficient method of desensitization for certain stimuli that are sometimes highly aversive: the saddle/girth pressure, clippers, aerosols, and needles. Desensitization with concurrent overshadowing appears to be comparatively rapid, particularly with highly aversive stimuli, possibly because attentional mechanisms are diverted to the more salient stimulus. It is important to note that, following the overshadowing procedure, the effects appear to be retained when assessed on subsequent days. Using 4 examples, this article presents a preliminary exploration of the beneficial use of a poorly understood, underutilized--yet promising--phenomenon that warrants further investigation.

Furthering Our Understanding of Therapist Knowledge and Attitudinal Measurement in Youth Community Mental Health.

PubMed

Okamura, Kelsie H; Hee, Puanani J; Jackson, David; Nakamura, Brad J

2018-02-19

Examining therapist evidence-based practice (EBP) knowledge seems an important step for supporting successful implementation. Advances in implementation science suggest a distinction between practice specific (i.e., knowing which practices are derived from the evidence base) and EBP process (i.e., integrating research evidence, clinical experience, client characteristics, and monitoring outcomes) knowledge. An examination of how these knowledge types are measured and relate to attitudes appears warranted. In our sample of 58 youth community therapists, both practice specific and EBP process knowledge accounted for EBP attitude scores, which varied by therapist demographic variables. Implications for measurement of therapist constructs and future research in identifying therapist predictors of EBP use and youth clinical improvement are discussed.

Does Success Of Arthroscopic Laser Surgery In The Knee Joint Warrant Its Extension To "Non-Knee" Joints?

NASA Astrophysics Data System (ADS)

Smith, Chadwick F.; Johansen, W. Edward; Vangness, C. Thomas; Yamaguchi, Ken; McEleney, Emmett T.; Bales, Peter

1987-03-01

One of the authors has performed 162 arthroscopic laser surgeries in the knee joint without any major complication. Other investigators have recently proposed diagnostic arthroscopy and arthroscopic surgery for "non-knee" joints. The authors have proposed that arthroscopic laser surgery he extended to "non-knee" joints. The authors have performed arthroscopic laser surgery on "non-knee" joints of twelve cadavers. One of the authors have performed one successful arthroscopic surgery on a shoulder joint with only a minor, transient complication of subcutaneous emphysema. Is laser arthroscopic surgery safe and effective in "non-knee" joints? The evolving answer appears to be a qualified "Yes," which needs to be verified by a multicenter trial.

21 CFR 1316.11 - Execution of warrants.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Execution of warrants. 1316.11 Section 1316.11 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Inspections § 1316.11 Execution of warrants. An administrative...

10 CFR 1045.17 - Classification levels.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Top Secret. The Director of Classification shall classify RD information Top Secret if it is vital to... exceptionally grave damage to the national security. Examples of RD information that warrant Top Secret... comprehensive to warrant designation as Top Secret. Examples of RD information that warrant Secret...

Identifying and prioritizing lower value services from Dutch specialist guidelines and a comparison with the UK do-not-do list.

PubMed

Wammes, Joost Johan Godert; van den Akker-van Marle, M Elske; Verkerk, Eva W; van Dulmen, Simone A; Westert, Gert P; van Asselt, Antoinette D I; Kool, R B

2016-11-25

The term 'lower value services' concerns healthcare that is of little or no value to the patient and consequently should not be provided routinely, or not be provided at all. De-adoption of lower value care may occur through explicit recommendations in clinical guidelines. The present study aimed to generate a comprehensive list of lower value services for the Netherlands that assesses the type of care and associated medical conditions. The list was compared with the NICE do-not-do list (United Kingdom). Finally, the feasibility of prioritizing the list was studied to identify conditions where de-adoption is warranted. Dutch clinical guidelines (published from 2010 to 2015) were searched for lower value services. The lower value services identified were categorized by type of care (diagnostics, treatment with and without medication), type of lower value service (not routinely provided or not provided at all), and ICD10 codes (international classification of diseases). The list was prioritized per ICD10 code, based on the number of lower value services per ICD10 code, prevalence, and burden of disease. A total of 1366 lower value services were found in the 193 Dutch guidelines included in our study. Of the lower value services, 30% covered diagnostics, 29% related to surgical and medical treatment without drugs primarily, and 39% related to drug treatment. The majority (77%) of all lower value services was on care that should not be offered at all, whereas the other 23% recommended on care that should not be offered routinely. ICD10 chapters that included most lower value services were neoplasms and diseases of the nervous system. Dutch guidelines appear to contain more lower value services than UK guidelines. The prioritization processes revealed several conditions, including back pain, chronic obstructive pulmonary disease, and ischemic heart diseases, where lower value services most likely occur and de-adoption is warranted. In this study, a comprehensive list of lower value services for Dutch hospital care was developed. A feasible method for prioritizing lower value services was established. Identifying and prioritizing lower value services is the first of several necessary steps in reducing them.

Cost-Effectiveness of Endoscopic Versus Microscopic Transsphenoidal Surgery for Pituitary Adenoma.

PubMed

Ament, Jared D; Yang, Zhuo; Khatchadourian, Vic; Strong, Edward B; Shahlaie, Kiarash

2018-02-01

Endoscopic transsphenoidal surgery (ETPS) has become increasingly popular for resection of pituitary tumors, whereas microscopic transsphenoidal surgery (MTPS) also remains a commonly used approach. The economic sustainability of new techniques and technologies is rarely evaluated in the neurosurgical skull base literature. The aim of this study was to determine the cost-effectiveness of ETPS compared with MTPS. A Markov model was constructed to conduct a cost-utility analysis of ETPS versus MTPS from a single-payer health care perspective. Data were obtained from previously published outcomes studies. Costs were based on Medicare reimbursement rates, considering covariates such as complications, length of stay, and operative time. The base case adopted a 2-year follow-up period. Univariate and multivariate sensitivity analyses were conducted. On average, ETPS costs $143 less and generates 0.014 quality-adjusted life years (QALYs) compared with MTPS over 2 years. The incremental cost-effectiveness ratio (ICER) is -$10,214 per QALY, suggesting economic dominance. The QALY benefit increased to 0.105 when modeled to 10 years, suggesting that ETPS becomes even more favorable over time. ETPS appears to be cost-effective when compared with MTPS because the ICER falls below the commonly accepted $50,000 per QALY benchmark. Model limitations and assumptions affect the generalizability of the conclusion; however, ongoing efforts to improve rhinologic morbidity related to ETPS would appear to further augment the marginal cost savings and QALYs gained. Further research on the cost-effectiveness of ETPS using prospective data is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

Premorbid (early life) IQ and later mortality risk: systematic review.

PubMed

Batty, G David; Deary, Ian J; Gottfredson, Linda S

2007-04-01

Studies of middle-aged and particularly older-aged adults found that those with higher scores on tests of IQ (cognitive function) had lower rates of later mortality. Interpretation of such findings potentially is hampered by the problem of reverse causality: such somatic diseases as diabetes or hypertension, common in older adults, can decrease cognitive function. Studies that provide extended follow-up of the health experience of individuals who had their (premorbid) IQ assessed in childhood and/or early adulthood minimize this concern. The purpose of the present report is to systematically locate, evaluate, and interpret the findings of all such studies. We systematically identified individual-level studies linking premorbid IQ with later mortality by using four approaches: search of electronic databases (MEDLINE, EMBASE, and PSYCHINFO); scrutiny of the reference sections of identified reports; search of our own files; and contact with researchers in the field. Study quality was assessed by using predefined criteria. Nine cohort studies met the inclusion criteria. Overall, study quality was moderate. All reports showed an inverse IQ-mortality relation; i.e., higher IQ scores were associated with decreased mortality risk. The nature of this relation (i.e., dose-response or threshold) and whether it differs by sex was unclear. The IQ-mortality association did not appear to be explained by reverse causality or selection bias. Confounding by other early-life factors also did not seem to explain the association, although some studies were not well characterized in this regard. Adult socioeconomic position appeared to mediate the IQ-mortality association in some studies, but this was not a universal finding. In all studies, higher IQ in the first two decades of life was related to lower rates of total mortality in middle to late adulthood. Some plausible mechanistic pathways exist, but further examination is required. The precise nature of the IQ-mortality relation (particularly in ethnic minorities and women) and the link between IQ and disease-specific outcomes also warrants further research.

Effects of the built environment on physical activity of adults living in rural settings.

PubMed

Frost, Stephanie S; Goins, R Turner; Hunter, Rebecca H; Hooker, Steven P; Bryant, Lucinda L; Kruger, Judy; Pluto, Delores

2010-01-01

To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings. Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted. Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded. Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature. Key characteristics and findings from the data are summarized in Tables 1 through 3. Twenty studies met inclusion and exclusion criteria. Positive associations were found among pleasant aesthetics, trails, safety/crime, parks, and walkable destinations. Research in this area is limited. Associations among elements of the BE and PA among adults appear to differ between rural and urban areas. Considerations for future studies include identifying parameters used to define rural, longitudinal research, and more diverse geographic sampling. Development and refinement of BE assessment tools specific to rural locations are also warranted.

Khat Use and Neurobehavioral Functions: Suggestions for Future Studies

PubMed Central

Hoffman, Richard; al’Absi, Mustafa

2010-01-01

Although there is a rich body of research available regarding the effect of acute and chronic khat dosing in animal models, research on the behavioral and cognitive effects of khat in human subjects is not extensive and several of the available studies have been done only in the context of observational and single-case studies. In light of the absence of a substantial literature on the neurobehavioral deficits associated with khat use and to provide a context that could be used to identify themes for future research we review previous research that has focused on other stimulant drugs. This review highlights multiple areas of neurocognitive deficit that have been identified in previous studies of individuals who have been chronic users of stimulants, such as amphetamines and methamphetamines. The review highlights a substantial body of evidence demonstrating a wide range of learning and memory impairments including deficits that persist during abstinence from active drug use. This review does not imply a similar khat effect, but due to some similarities pharmacologically between the active components of khat (cathinone and cathine) and amphetamines, future studies examining these same domains of cognitive functioning in chronic khat users and abstinent khat users appears to be warranted, if possible using some of the same or similar laboratory measures. PMID:20553832

Open-label pilot study of memantine in the treatment of compulsive buying.

PubMed

Grant, Jon E; Odlaug, Brian L; Mooney, Marc; O'Brien, Robert; Kim, Suck Won

2012-05-01

Although compulsive buying (CB) is relatively common, pharmacotherapy research for CB is limited. Memantine, an N-methyl-D-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive behaviors, suggesting it may help individuals with CB. Nine patients (8 females) with CB were enrolled in a 10-week open-label treatment study of memantine (dose ranging from 10 to 30 mg/d). Participants were enrolled from December 2008 until May 2010. The primary outcome measure was change from baseline to study endpoint on the Yale-Brown Obsessive Compulsive Scale-Shopping Version (Y-BOCS-SV). Of the 9 participants, 8 (88.9%) completed the 10-week study. Y-BOCS-SV scores decreased from a mean of 22.0 ± 1.3 at baseline to 11.0 ± 5.3 at endpoint (P < .001). Hours spent shopping per week and money spent shopping both decreased significantly (P < .001). The mean effective dose of memantine was 23.4 ± 8.1 mg/d. Memantine treatment was associated with diminished impulsive buying and improvements on cognitive tasks of impulsivity. In addition, the medication was well-tolerated. These findings suggest that pharmacologic manipulation of the glutamate system may target the impulsive behavior underlying CB. Placebo-controlled, double-blind studies are warranted in order to confirm these preliminary findings in a controlled design.

32 CFR 504.2 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... administrative summons or subpoena for access to financial records. (d) Search warrant. (1) A law enforcement office may obtain financial records by using a search warrant obtained under Rule 41 of the Federal Rules of Criminal Procedure in appropriate cases. (2) No later than 90 days after the search warrant is...

8 CFR 287.9 - Criminal search warrant and firearms policies.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Criminal search warrant and firearms policies. 287.9 Section 287.9 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS FIELD OFFICERS; POWERS AND DUTIES § 287.9 Criminal search warrant and firearms policies. (a) A...

19 CFR 162.11 - Authority to procure warrants.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Authority to procure warrants. 162.11 Section 162.11 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Search Warrants § 162.11 Authority to procure...

8 CFR 103.22 - Records exempt in whole or in part.

Code of Federal Regulations, 2011 CFR

2011-01-01

... classification under the criteria of the Executive Order. Information which no longer warrants classification... continues to warrant classification, the individual shall be advised that the information sought is classified; that it has been reviewed and continues to warrant classification; and that it has been exempted...

Autonomic Evaluation of Patients With Gastroparesis and Neurostimulation: Comparisons of Direct/Systemic and Indirect/Cardiac Measures

PubMed Central

Stocker, Abigail; Abell, Thomas L.; Rashed, Hani; Kedar, Archana; Boatright, Ben; Chen, Jiande

2016-01-01

Background Disorders of nausea, vomiting, abdominal pain, and related problems often are manifestations of gastrointestinal, neuromuscular, and/or autonomic dysfunction. Many of these patients respond to neurostimulation, either gastric electrical stimulation or electroacupuncture. Both of these therapeutic techniques appear to influence the autonomic nervous system which can be evaluated directly by traditional testing and indirectly by heart rate variability. Methods We studied patients undergoing gastric neuromodulation by both systemic autonomic testing (39 patients, six males and 33 females, mean age 38 years) and systemic autonomic testing and heart rate variability (35 patients, seven males and 28 females, mean age 37 years) testing before and after gastric neuromodulation. We also performed a pilot study using both systemic autonomic testing and heart rate variability in a small number of patients (five patients, all females, mean age 48.6 years) with diabetic gastroparesis at baseline to compare the two techniques at baseline. Systemic autonomic testing and heart rate variability were performed with standardized techniques and gastric electrical stimulation was performed as previously described with electrodes implanted serosally in the myenteric plexus. Results Both systemic autonomic testing and heart rate variability measures were often abnormal at baseline and showed changes after gastric neuromodulation therapy in two groups of symptomatic patients. Pilot data on a small group of similar patients with systemic automatic nervous measures and heart rate variability showed good concordance between the two techniques. Conclusions Both traditional direct autonomic measures and indirect measures such as heart rate variability were evaluated, including a pilot study of both methods in the same patient group. Both appear to be useful in evaluation of patients at baseline and after stimulation therapies; however, a future full head-to-head comparison is warranted. PMID:27785318

Sex differences in the uptake and disposition of perfluorooctanoic acid in fathead minnows after oral dosing.

PubMed

Lee, Jonathan J; Schultz, Irvin R

2010-01-01

Perfluorooctanoic acid (PFOA) among other perfluorinated acids is becoming recognized as a ubiquitous environmental contaminant. PFOA is resistant to environmental degradation and appears to undergo no biotransformation in animals. Previous toxicokinetic studies in rodents have indicated that urinary excretion is the most important elimination pathway once PFOA has been absorbed. In some species such as rats, large sex-related differences in urinary excretion have been reported, with females having a much shorter blood or plasma elimination half-life than that of males. It is unknown whether this phenomenon occurs in fish. Therefore, this study determined the disposition of PFOA in male and female fathead minnows (Pimephales promelas) after a single oral dose of PFOA. After dosing, minnows were subsequently euthanized at various times until 336 h postdosing and the PFOA concentration was measured in plasma, gonads, and fish carcass. The concentration-time profiles of PFOA were then analyzed using toxicokinetic methods. The results indicated a clear sex difference in the elimination of PFOA. The plasma elimination half-life of PFOA in female minnows was 6.3 h while in male minnows it was 68.5 h. Pretreatment of female minnows with the synthetic androgen trenbolone substantially delayed the elimination of PFOA, causing the elimination half-life to increase to 25.3 h. In males, pretreatment with the synthetic estrogen ethynylestradiol (EE2) had little effect on PFOA toxicokinetics. These results indicate that the sex differences in PFOA elimination in fathead minnows can at least partially be modulated by exposure to synthetic sex steroids. Whether sex differences in PFOA elimination in minnows is attributable to differences in renal transport activity, as it appears to be for rodents, is unknown at present but clearly warrants further study.

Supramaximal Eccentrics Versus Traditional Loading in Improving Lower-Body 1RM: A Meta-Analysis.

PubMed

Buskard, Andrew N L; Gregg, Heath R; Ahn, Soyeon

2018-06-11

Guidelines for improving maximal concentric strength through resistance training (RT) have traditionally included large muscle-group exercises, full ranges of motion, and a load approximating 85% of the 1-repetition maximum (1RM). Supramaximal eccentric training (SME; controlled lowering of loads above the concentric 1RM) has also been shown to be effective at increasing concentric 1RM in the lower body, but concerns regarding injury risk, postexercise soreness, and null benefit over traditional methods (TRAD) may limit the practical utility of this approach. The purpose of this study was to determine whether SME elicits greater lower-body strength improvements than TRAD. Key inclusion criteria were regular exercise modalities typical of nonspecialized exercise facilities (e.g., leg press; key exclusion: isokinetic dynamometer) and at least 6 weeks of RT exposure, leading to 5 studies included in the current meta-analysis. Unbiased effect-size measures that quantify the mean difference in lower-body 1RM between SME and TRAD were extracted. Supramaximal eccentric training did not appear to be more effective than TRAD at increasing lower-body 1RM ([Formula: see text] = .33, SE = .26, z = 1.26, 95% CI [-0.20, 0.79], p = .20, I 2  = 56.78%) under a random-effects model where between-study variance was estimated using maximum likelihood estimation ([Formula: see text] 2 = .25). The selection of SME over TRAD in RT programs designed to increase lower-body 1RM does not appear warranted in all populations. Further research should clarify the merit of periodic SME in TRAD-dominant RT programs as well as whether a differential effect exists in trained individuals.

8 CFR 287.3 - Disposition of cases of aliens arrested without warrant.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Disposition of cases of aliens arrested without warrant. 287.3 Section 287.3 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS FIELD OFFICERS; POWERS AND DUTIES § 287.3 Disposition of cases of aliens arrested without warrant...

Taming the Warrant in Toulmin's Model of Argument

ERIC Educational Resources Information Center

Warren, James E.

2010-01-01

In the Toulmin model, arguments begin with a "claim" supported by "data." The movement from claim to data is authorized by a general, unstated proposition Stephen E. Toulmin calls the "warrant." Unlike all other components of the Toulmin model, warrants usually remain implicit in an argument; they are the unspoken assumptions that bind together…

19 CFR 162.13 - Search of rooms not described in warrant.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Search of rooms not described in warrant. 162.13 Section 162.13 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Search Warrants § 162.13 Search of...

Ultrasound to Detect Pressure-related Deep Tissue Injuries in Adults Admitted via the Emergency Department: A Prospective, Descriptive, Pilot Study.

PubMed

Scheiner, Jonathan; Farid, Karen; Raden, Mark; Demisse, Seleshi

2017-03-01

Stage 4 pressure ulcers (PUs) start with tissue death at the level of the bone, also known as deep tissue injury (DTI). Studies have shown the appearance of DTI on the skin is delayed for several days after the original pressure-related injury to the deep soft tissues. Studies also suggest DTI can be seen using ultrasound (US) technology. A prospective, descriptive, correlational pilot study was conducted to evaluate the use of US technology to detect DTI in the soft tissues that are not visible on the skin upon hospital admission. Study participants included a convenience sample of 33 persons at risk for PUs (ie, Braden score <18) admitted through the emergency department. Each participant had US scans of 13 common PU body sites. All scans were documented in the radiologist report in the electronic medical record. Creatinine phosphokinase, calcium levels, and urine myoglobin levels also were assessed upon enrollment. Skin failure risk factors (SFRFs), including fever, hypotension, weight loss, coagulopathy, and acidosis/respiratory failure, also were documented. Patients were examined for skin PUs every day for 7 days after US scan. Twenty-three (23) patients completed the study. US scans identified pressure necrosis at 2 levels: bone (54 positive [US+]) and subcutaneous (SC); 79 US+, respectively). US+ bone sites resulted in 5 PUs appearing 6 to 7 days post-admission (sensitivity = 100%, specificity 84.7%, positive predictive value 10%, and negative predictive value 100%), indicating all DTI that later became purple skin DTI were detected by the US. US+ SC sites, located immediately under the skin, yielded 5 PUs appearing on day 2 after admission (sensitivity 100%, specificity 74.8%, positive predictive value 6.3%, and negative predictive value 100%). The participants with PU occurrence in both bone and SC groups had low Braden scores (bone group mean = 13.25, SC group mean = 11.2). Study patients who were positive for PU also had >4 SFRFs. Creatinine phosphokinase, calcium, and myoglobin levels were inconsistent and did not correlate with US+ scans. These observations warrant larger studies to confirm findings and optimize the validity of US screening for DTI in select populations, which may help improve protocols of care and PU admission documentation. The preliminary results suggest inclusion of the Braden Scale score and known PU risk factors may improve the positive predictive value of this test.

Reduced Allergy and Immunoglobulin E among Adults with Intra-cranial Meningioma Compared to Controls

PubMed Central

Wiemels, Joseph L.; Wrensch, Margaret; Sison, Jennette D.; Zhou, Mi; Bondy, Melissa; Calvocoressi, Lisa; Black, Peter M.; Yu, Herbert; Schildkraut, Joellen M.; Claus, Elizabeth B.

2012-01-01

Meningioma, the most frequent tumor in the central nervous system, has few recognized risk factors. We explored the role of allergies in a population-based case-control consortium study of meningioma in five geographic areas. We also studied serum levels of a marker of atopic allergy (IgE) in a subset of study participants, a first for a study on meningioma. Participants (N = 1,065) with surgically resected, pathologically confirmed meningioma and controls (N = 634) selected via random-digit dialing were recruited and interviewed. Cases were less likely than controls to report history of physician-diagnosed allergy [odds ratio (OR) = 0.64; 95% confidence interval (95% CI): 0.51 – 0.80]. Also, cases (N = 295) had lower total serum IgE than controls [N = 192; OR = 0.85, 95% CI: 0.75–0.98 for each unit of Ln(IgE)]. Similar to glioma and cancers at several other sites, meningioma appears to have an inverse relationship with history of allergies and a biomarker of atopic allergy. Since some common opposing predisposition or developmental processes for allergy and meningioma may exist, further research into immune processes that can affect the incidence and natural history of meningioma is warranted. PMID:21520030

Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort.

PubMed

Tracy, Daniel; Hahn, Judith A; Fuller Lewis, Crystal; Evans, Jennifer; Briceño, Alya; Morris, Meghan D; Lum, Paula J; Page, Kimberly

2014-05-29

Female injection drug users (IDUs) may report differences in injection behaviours that put them at greater risk for hepatitis C virus (HCV). Few studies have examined these in association with HCV incidence. Longitudinal data from a cohort of 417 HCV-uninfected IDU aged 30 or younger were analysed. Cox proportional hazards was used to model female sex as a predictor of new HCV infection. General estimating equation (GEE) analysis was used to model female sex as a predictor of HCV-associated risk behaviour prospectively. Women were significantly more likely than men to become infected with HCV during study follow-up (HR 1.4, p<0.05), and were also more likely than men to report high-risk injecting behaviours, especially in the context of sexual and injecting relationships. Sex differences in injecting behaviours appeared to explain the relationship between sex and HCV infection. Young women's riskier injection practices lead to their higher rates of HCV infection. Further study on the impact of intimate partnership on women's risk behaviour is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Recruiting African American Churches to Participate in Research: The Learning and Developing Individual Exercise Skills for a Better Life Study

PubMed Central

Whitt-Glover, Melicia C.; Borden, Shanice L.; Alexander, Dayna S.; Kennedy, Betty M.; Goldmon, Moses V.

2016-01-01

Physical activity among African Americans (AA) is low; effective intervention strategies are needed. Community-based settings are useful for delivering health-related interventions in racial/ethnic minority communities. This article describes strategies used to recruit churches for participation in a 22-month intervention designed to increase physical activity levels in AA women. Initial recruitment efforts, led by AA study staff, included direct mailers, phone calls, and in-person meetings with church representatives. After 10 months, only five churches were enrolled. Seven community members with existing partnerships/contacts in the faith community were subsequently hired and an additional 26 churches were enrolled within 6 months. Overall response rate was 45%, and churches required 3.5 ± 3.0 months of multiple contacts prior to enrollment. The main primary contacts within churches were individuals with personal interest in the program and pastors. Prior relationship between the research team and churches did not appear to influence church enrollment as much as community member recruiters. The current study identifies several potential strategies that may be useful for increasing success in efforts to recruit AA churches into studies. Additional research is warranted that tests and compares a variety of recruitment strategies to determine the most successful strategies for recruitment in different populations. PMID:26724311

Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada.

PubMed

Thomas, Gerald; Lucas, Philippe; Capler, N Rielle; Tupper, Kenneth W; Martin, Gina

2013-03-01

This paper reports results from a preliminary observational study of ayahuasca-assisted treatment for problematic substance use and stress delivered in a rural First Nations community in British Columbia, Canada. The "Working with Addiction and Stress" retreats combined four days of group counselling with two expert-led ayahuasca ceremonies. This study collected pre-treatment and six months follow-up data from 12 participants on several psychological and behavioral factors related to problematic substance use, and qualitative data assessing the personal experiences of the participants six months after the retreat. Statistically significant (p < 0.05) improvements were demonstrated for scales assessing hopefulness, empowerment, mindfulness, and quality of life meaning and outlook subscales. Self-reported alcohol, tobacco and cocaine use declined, although cannabis and opiate use did not; reported reductions in problematic cocaine use were statistically significant. All study participants reported positive and lasting changes from participating in the retreats. This form of ayahuasca-assisted therapy appears to be associated with statistically significant improvements in several factors related to problematic substance use among a rural aboriginal population. These findings suggest participants may have experienced positive psychological and behavioral changes in response to this therapeutic approach, and that more rigorous research of ayahuasca-assisted therapy for problematic substance use is warranted.

Prior medical conditions and medication use and risk of non-Hodgkin lymphoma in Connecticut United States women.

PubMed

Zhang, Yawei; Holford, Theodore R; Leaderer, Brian; Zahm, Shelia Hoar; Boyle, Peter; Morton, Lindsay McOmber; Zhang, Bing; Zou, Kaiyong; Flynn, Stuart; Tallini, Giovanni; Owens, Patricia H; Zheng, Tongzhang

2004-05-01

To further investigate the role of prior medical conditions and medication use in the etiology of non-Hodgkin lymphoma (NHL), we analyzed the data from a population-based case-control study of NHL in Connecticut women. A total of 601 histologically confirmed incident cases of NHL and 717 population-based controls were included in this study. In-person interviews were administered using standardized, structured questionnaires to collect information on medical conditions and medication use. An increased risk was found among women who had a history of autoimmune disorders (such as rheumatoid arthritis, lupus erythematosus, Sjogren's syndrome, and multiple sclerosis), anemia, eczema, or psoriasis. An increased risk was also observed among women who had used steroidal anti-inflammatory drugs and tranquilizers. A reduced risk was found for women who had scarlet fever or who had used estrogen replacement therapy, aspirin, medications for non-insulin dependent diabetes, HMG-CoA reductase inhibitors, or beta-adrenergic blocking agents. Risk associated with past medical history appeared to vary based on NHL subtypes, but the results were based on small number of exposed subjects. A relationship between certain prior medical conditions and medication use and risk of NHL was observed in this study. Further studies are warranted to confirm our findings.

Acute hematogenous septic arthritis of the knee in adults.

PubMed

Sreenivas, T; Nataraj, A R; Menon, Jagdish

2013-10-01

To evaluate the factors associated with acute hematogenous septic arthritis of the knee in adults and to assess the outcome after open knee arthrotomy. We performed a prospective evaluation of 26 adult patients with acute nongonococcal septic arthritis of the knee presenting within 7 days. All patients underwent open knee arthrotomy, and final evaluation by means of Knee society score of the affected knee was compared with the contra lateral normal knee. The average duration of symptoms at the time of presentation was 3.9 days. Staphylococcus aureus was the commonest bacteria isolated in 17 (65.4 %) patients. The average duration of follow-up in our study was 18.5 months. In our study, Knee society score decreases as the age of the patient advances (P < 0.05) and also it was found to be low (P < 0.05) in the affected knee as compared to contra lateral normal knee. Our study shows that age of the patient at presentation is critical as it shows significant reduction in knee score. This explains that the septic arthritis may contribute to the progression of age-related degeneration of the knee joint. There appears to be no definite contributing factors or conditions associated with acute hematogenous septic arthritis of the knee in adults, although further study may be warranted regarding this matter.

Are there gender differences in quality of life and symptomatology between fibromyalgia patients?

PubMed

Aparicio, Virginia A; Ortega, Francisco B; Carbonell-Baeza, Ana; Femia, Pedro; Tercedor, Pablo; Ruiz, Jonatan R; Delgado-Fernández, Manuel

2012-07-01

The purpose of this study is to examine gender differences in quality of life (QoL) and symptomatology in fibromyalgia (FM) patients. A total of 20 men (48.0 ± 8.0 years) and 78 women (49.8 ± 7.2 years) with FM participated in the study (age range 31-63 years). Health-related QoL and FM impact were assessed by means of the Spanish versions of the Short-Form-36 Health Survey (SF36) and the Fibromyalgia Impact Questionnaire (FIQ), respectively. Comparisons in QoL were performed using one-way analysis of covariance adjusted by age and body mass index (BMI), and comparisons in FIQ dimensions were performed using Mann-Whitney test. Overall FM impact, as measured by FIQ-total score (p = .01) and FIQ-physical impairment (p = .02) was higher in men, whereas women presented higher values of FIQ-fatigue and FIQ-morning tiredness (p = .04) and less SF36-vitality (p = .02). Therefore, women appear to feel more fatigue, whereas men present higher FM overall impact. Due to the small number of men included in this study and the consequent small statistical power, these results should be taken as preliminary. Higher powered studies are warranted to further address gender differences in FM in order to design more successful treatments.

Dietary folate, vitamin B-12, vitamin B-6 and incident Alzheimer's disease: the cache county memory, health and aging study.

PubMed

Nelson, C; Wengreen, H J; Munger, R G; Corcoran, C D

2009-12-01

To examine associations between dietary and supplemental folate, vitamin B-12 and vitamin B-6 and incident Alzheimer's disease (AD) among elderly men and women. Data collected were from participants of the Cache County Memory, Health and Aging Study, a longitudinal study of 5092 men and women 65 years and older who were residents of Cache County, Utah in 1995. Multistage clinical assessment procedures were used to identify incident cases of AD. Dietary data were collected using a 142-item food frequency questionnaire. Cox Proportional Hazards (CPH) modeling was used to determine hazard ratios across quintiles of micronutrient intake. 202 participants were diagnosed with incident AD during follow-up (1995-2004). In multivariable CPH models that controlled for the effects of gender, age, education, and other covariates there were no observed differences in risk of AD or dementia by increasing quintiles of total intake of folate, vitamin B-12, or vitamin B-6. Similarly, there were no observed differences in risk of AD by regular use of either folate or B6 supplements. Dietary intake of B-vitamins from food and supplemental sources appears unrelated to incidence of dementia and AD. Further studies examining associations between dietary intakes of B-vitamins, biomarkers of B-vitamin status and cognitive endpoints are warranted.

Is Bringing Back Warrant Officers the Answer A Loot at How They Could Work in the Air Force Cyber Operations Career Field

DTIC Science & Technology

2017-03-16

warrant officers in the Navy, they did lead directly to their place being cemented firmly in the Navy’s rank structure. The Navy exclusively...Dennis Steele , “The U.S. Army Warrant Officer Corps: Still a Work in Progress,” Army 62 no. 7 (July 2012), 40. 65. Department of the Army, The Army...force- cyber-secure.aspx. Steele , Dennis. “The U.S. Army Warrant Officer Corps: Still a Work in Progress.” Army 62 no. 7 (July 2012): 39-41

Measuring resident well-being: impostorism and burnout syndrome in residency.

PubMed

Legassie, Jenny; Zibrowski, Elaine M; Goldszmidt, Mark A

2008-07-01

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

Waterpipe industry products and marketing strategies: analysis of an industry trade exhibition

PubMed Central

Jawad, Mohammed; Nakkash, Rima T; Hawkins, Ben; Akl, Elie A

2016-01-01

Introduction Understanding product development and marketing strategies of transnational tobacco companies (TTCs) has been of vital importance in developing effective tobacco control policy. However, comparatively little is known of the waterpipe tobacco industry, which TTCs have recently entered. This study aimed to gain an understanding of waterpipe tobacco products and marketing strategies by visiting a waterpipe trade exhibition. Methods In April 2014 the first author attended an international waterpipe trade exhibition, recording descriptions of products and collecting all marketing items available. We described the purpose and function of all products, and performed a thematic analysis of messages in marketing material. Results We classified the waterpipe products into seven categories and noted product variation within categories. Electronic waterpipe products (which mimic electronic cigarettes) rarely appeared on waterpipe tobacco marketing material, but were displayed just as widely. Claims of reduced harm, safety and quality were paramount on marketing materials, regardless of whether they were promoting waterpipe tobacco, waterpipe tobacco-substitutes, electronic waterpipes or charcoal. Conclusions Waterpipe products are diverse in nature and are marketed as healthy and safe products. Furthermore, the development of electronic waterpipe products appear to be closely connected with the electronic cigarette industry, rather than the waterpipe tobacco manufacturers. Tobacco control policy must evolve to take account of the vast and expanding array of waterpipe products, and potentially also charcoal products developed for waterpipe smokers. We recommend tobacco-substitutes be classified as tobacco products. Continued surveillance of the waterpipe industry is warranted. PMID:26149455

Interactions between methylmercury and selenomethionine injected into mallard eggs

USGS Publications Warehouse

Klimstra, J.D.; Yee, J.L.; Heinz, G.H.; Hoffman, D.J.; Stebbins, K.R.

2012-01-01

Methylmercury chloride and seleno-L-methionine were injected separately or in combinations into mallard eggs (Anas platyrhynchos), and embryo mortality and teratogenic effects (deformities) were modeled using a logistic regression model. Methylmercury was injected at doses that resulted in concentrations of 0, 0.2, 0.4, 0.8, and 1.6 µg/g Hg in the egg on a wet weight basis and selenomethionine at doses that resulted in concentrations of 0, 0.1, 0.2, 0.4, and 0.6 µg/g Se in the egg, also on a wet weight basis. When selenomethionine and methylmercury were injected separately, hatching probability decreased in both cases. However, when methylmercury was injected at 1.6 µg/g in combination with selenomethionine at 0.2 µg/g, the presence of the methylmercury resulted in less embryo mortality than had been seen with 0.2 µg/g Se by itself, but it increased the number of deformed embryos and hatchlings. Selenomethionine appeared to be more embryotoxic than equivalent doses of methylmercury when injected into eggs, and both injected methylmercury and selenomethionine were more toxic to mallard embryos than when deposited naturally in the egg by the mother. The underlying mechanisms behind the interactions between methylmercury and selenomethionine and why methylmercury appeared to improve hatching probability of Se-dosed eggs yet increased deformities when the two compounds were combined are unclear. These findings warrant further studies to understand these mechanisms in both laboratory and field settings.

Risk of Osteosarcoma in Dogs After Open Fracture Fixation.

PubMed

Arthur, Elizabeth G; Arthur, Gerald L; Keeler, Matthew R; Bryan, Jeffrey N

2016-01-01

To critically evaluate whether open fracture fixation is a significant risk factor for latent osteosarcoma development. Case-control study. Dogs undergoing open fracture repair and dogs diagnosed with osteosarcoma. Records were retrieved from the Veterinary Medical Database VMDB (1970-2000) for dogs undergoing surgical repair of a fracture and dogs diagnosed with osteosarcoma. Dogs with open reduction of joint luxation, dogs diagnosed with bacterial cystitis, and dogs diagnosed with urinary bladder transitional cell carcinoma (UBTCC) were queried as comparison populations. Relative risk for osteosarcoma development was determined. From a population of 19,041 fractures treated surgically, 15 of those dogs subsequently appeared in the VMDB with osteosarcoma affecting the same bone. The relative risk of a fracture repair and associated orthopedic implants and osteosarcoma occurrence was equivalent to the relative risk of open joint reduction and osteosarcoma occurrence (95% confidence interval; 0.998-1.00). The relative risk of having bacterial cystitis and appearing again in the VMDB with UBTCC was higher than the risk of open fracture repair and a subsequent diagnosis of osteosarcoma (P < .02). The incidence of fracture-related osteosarcoma may be significantly less than previously estimated based on cases queried from the VMDB. Although possible cases of implant-associated osteosarcoma were identified, their occurrence was rare. Elective implant removal for the purpose of reducing the risk of osteosarcoma after fracture repair may not be warranted and merits further investigation. © Copyright 2015 by The American College of Veterinary Surgeons.

Controlling the burn and fueling the fire: defining the role for the alarmin interleukin-33 in alloimmunity.

PubMed

Liu, Quan; Turnquist, Heth R

2016-02-01

The purpose of this review is to provide a general update on recent developments in the immunobiology of IL-33 and IL-33-targeted immune cells. We also discuss emerging concepts regarding the potential role IL-33 appears to play in altering alloimmune responses mediating host-versus-graft and graft-versus-host alloresponses. Stromal cells and leukocytes display regulated expression of IL-33 and may actively or passively secrete this pleotropic cytokine. Type 2 innate lymphoid cells and a large proportion of tissue resident regulatory T cells (Treg) express membrane-bound suppressor of tumorigenicity 2 (ST2), the IL-33 receptor. Although Treg are appreciated suppressors of the inflammatory function of immune cells, both type 2 innate lymphoid cells and tissue resident Treg could play key roles in tissue repair and homeostasis. The functions of IL-33 in transplantation are poorly understood. However, like other disease models, the functions of IL-33 in alloimmunity appear to be quite pleiotropic. IL-33 is associated with immune regulation and graft protection in cardiac transplant settings. Yet, it is highly proinflammatory and stimulates lethal graft-versus-host disease through its capacity to stimulate type 1 immunity. Intensive studies on IL-33/ST2 signaling pathways and ST2 cell populations in solid organ and cell transplantation are warranted. A better understanding of this important pathway will provide promising therapeutic targets controlling pathogenic alloimmune responses, as well as potentially facilitating the function of regulatory and reparative immune cells posttransplantation.

Bacterial Sepsis in Patients with Visceral Leishmaniasis in Northwest Ethiopia

PubMed Central

Takele, Yegnasew; Woldeyohannes, Desalegn; Tiruneh, Moges; Mohammed, Rezika; Lynen, Lutgarde; van Griensven, Johan

2014-01-01

Background and Objectives. Visceral leishmaniasis (VL) is one of the neglected diseases affecting the poorest segment of world populations. Sepsis is one of the predictors for death of patients with VL. This study aimed to assess the prevalence and factors associated with bacterial sepsis, causative agents, and their antimicrobial susceptibility patterns among patients with VL. Methods. A cross-sectional study was conducted among parasitologically confirmed VL patients suspected of sepsis admitted to the University of Gondar Hospital, Northwest Ethiopia, from February 2012 to May 2012. Blood cultures and other clinical samples were collected and cultured following the standard procedures. Results. Among 83 sepsis suspected VL patients 16 (19.3%) had culture confirmed bacterial sepsis. The most frequently isolated organism was Staphylococcus aureus (68.8%; 11/16), including two methicillin-resistant isolates (MRSA). Patients with focal bacterial infection were more likely to have bacterial sepsis (P < 0.001). Conclusions. The prevalence of culture confirmed bacterial sepsis was high, predominantly due to S. aureus. Concurrent focal bacterial infection was associated with bacterial sepsis, suggesting that focal infections could serve as sources for bacterial sepsis among VL patients. Careful clinical evaluation for focal infections and prompt initiation of empiric antibiotic treatment appears warranted in VL patients. PMID:24895569

Very low H O H bending frequencies. IV. Fourier transform infrared spectra of synthetic dittmarite

NASA Astrophysics Data System (ADS)

Šoptrajanov, Bojan; Stefov, Viktor; Kuzmanovski, Igor; Jovanovski, Gligor; Lutz, H. Dieter; Engelen, Bernward

2002-08-01

The Fourier transform infrared spectra of MgNH 4PO 4·H 2O (the synthetic analogue of the mineral dittmarite) and of a series of its partially deuterated analogues have been studied as a part of our continuous work on compounds exhibiting very low water bending frequencies. Although, the presence of ammonium bands makes the assignments in this case more difficult than for the potassium analogues, the isomorphism between the compounds of the MNH 4PO 4·H 2O type (M=Mg, Co, Ni, Mn and one of the polymorphs of CdNH 4PO 4·H 2O) and those which contain potassium instead of ammonium as well as the careful analysis of the spectra warrant the conclusion that in the presently studied compound the water bending mode appears at a frequency which is far more than 100 cm -1 lower than in the gaseous water. The spectra clearly show that the ammonium ions in the structure are involved in quite strong hydrogen bonds, a characteristic which is a precondition for a material to behave as a protonic conductor.

Insights into the enhancement of the ASB benthal solids digestion rate.

PubMed

Mahmood, Talat

2008-05-01

Aerated stabilization basins (ASB) accumulate benthal solids as they provide biotreatment to wastewaters. The accumulated solids must digest at a rate that matches the rate of settling of fresh solids in order to maintain the water column depth at the design value. In practice, however, the deposited solids digest at rates much slower than the fresh deposition rates, resulting in solids accumulation in the system. Excessive build-up of solids warrants dredging or abandoning the solids-filled cells in favour of opening new ones, often due to prohibitive dredging costs. An investigating study on factors affecting digestion rate was carried out using benthal solids from a pulp and paper ASB. The rate of digestion was not limited by the lack of macronutrients N, P, and S in the system or by toxicity due to ammonia or sulphide. Oxidation-reduction potential and pH were found conducive to anaerobic digestion throughout the 1120-day study. However, the generation of volatile organic acids from liquefaction/fermentation of solid substrate appeared to be a major factor limiting the digestion rate. Based on laboratory data, operating an ASB in the optimal mesophilic temperature range could be a practical way of enhancing the benthal solids digestion rate.

State of the evidence: Cannabinoids and cancer pain-A systematic review.

PubMed

Tateo, Sydney

2017-02-01

Cannabinoids are widely used to alleviate intractable symptoms such as pain, nausea, and muscle spasticity. The purpose of this review was to ascertain the current state of the science regarding use of cannabinoids for cancer pain. Four electronic databases were searched for randomized control trials of cannabinoids and cancer pain. Studies included examined the analgesic effects of cannabinoids for cancer pain. Methodological quality was assessed using the Jadad scale. Eight randomized control trials met the inclusion criteria for review. Most trials found analgesic effects from cannabinoids when compared to placebo, although not all associations reached statistical significance. The analgesic effects of cannabinoids were also limited by dose-dependent side effects. Side effects most commonly reported were changes in cognition, sedation, and dizziness. There is evidence that cannabinoids are effective adjuvants for cancer pain not completely relieved by opioid therapy, but there is a dearth of high-quality studies to support a stronger conclusion. Cannabinoids appear to be safe in low and medium doses. Methodological limitations of the trials limited the ability to make sound conclusions. Further research is warranted before efficacy, safety, and utility of cannabinoids for cancer pain can be determined. ©2016 American Association of Nurse Practitioners.

Effectiveness of wearable defibrillators: systematic review and quality of evidence.

PubMed

Uyei, Jennifer; Braithwaite, R Scott

2014-04-01

The objectives of this systematic literature review were to identify all published literature on wearable defibrillators, assess the wearable defibrillator's efficacy and effectiveness in general and among specific patient groups, including post-myocardial infarction, post coronary artery bypass grafting or percutaneous coronary intervention, non-ischemic cardiomyopathy, and ischemic cardiomyopathy, and to evaluate the quality of evidence. The search and synthesis was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation and the Newcastle Ottawa Scale. A total of thirty-six articles and conference abstracts from thirty-three studies were included in the review. It appears that wearable defibrillator use compared with no defibrillator use reduces the chance of ventricular tachycardia and ventricular fibrillation (VT/VF) associated deaths by an absolute risk reduction of approximately 1 percent, achieved by averting approximately 4/5th of all VT/VF associated deaths. The quality of evidence was low to very low quality, such that our confidence in the reported estimates is weak. To validate beneficial results, further investigation using robust study designs conducted by independent researchers is warranted.

Investigation of a Possible Link Between Vaccination and the 2010 Sheep Pox Epizootic in Morocco.

PubMed

Haegeman, A; Zro, K; Sammin, D; Vandenbussche, F; Ennaji, M M; De Clercq, K

2016-12-01

Sheep pox is endemic in most parts of Northern Africa and has the potential to cause severe economic problems. Live attenuated vaccines are used in Morocco, and in many other countries, to control the disease. Sheep pox virus (SPPV) re-appeared in 2010 causing a nodular clinical form previously not observed in Morocco. The severe clinical signs observed during the course of this outbreak and initial reports citing similarity in nucleotide sequence between the Moroccan vaccine strain and field isolates warranted a more in depth analysis of this epizootic. In this study, sequence analysis showed that isolates obtained from four provinces of eastern Morocco were identical, demonstrating that a single SPPV strain was responsible for the 2010 epizootic. In addition, the genome fragments sequenced and phylogenetic analyses undertaken as part of this study showed significant differences between field isolates and the Moroccan vaccine strain. New PCR methods were developed to differentiate between wild-type isolates and vaccine strains of SPPV. Using these methods, no trace of wild-type SPPV was found in the vaccine and no evidence was found to suggest that the vaccine strain was causing clinical disease. © 2015 Blackwell Verlag GmbH.

Left ventricular dysfunction after closure of large patent ductus arteriosus.

PubMed

Galal, M Omar; Amin, Mohamed; Hussein, Arif; Kouatli, Amjad; Al-Ata, Jameel; Jamjoom, Ahmed

2005-03-01

Changes in left ventricular dimensions and performance were studied in 43 patients after transcatheter occlusion or surgical ligation of patent ductus arteriosus. The patients were assigned to 2 groups based on their ductal diameter: >/= 3.1 mm to group A (n = 27) and

Decreases in tanning behaviors following a short online survey: Potential for prevention?

PubMed

Rodgers, Rachel F; Franko, Debra L; Gottlieb, Mark; Daynard, Richard

2015-01-01

To date, tanning prevention programs have led to limited success. The aim of the present study was to investigate potential unexpected prevention effects of completing an online survey focused on tanning attitudes, behaviors, and knowledge among female college tanners. A sample of 92 female undergraduate students from the USA, mean age = 20.09, SD = 1.41 years, who engaged in indoor tanning completed an online survey assessing awareness of tanning-related health risks, appearance-based motivations to tan and not to tan, media literacy related to tanning marketing, and tanning behaviors in 2013. Four months later, participants were invited to complete a follow-up survey assessing tanning intentions and behaviors since completing the initial survey. Fifty-one participants (55%) completed the follow-up questions, of whom 43 (84.3%) reported having decreased or ceased engaging in indoor tanning. In addition participants provided comments indicating that completing the survey had lead to decreases in their tanning behaviors. Our study presents novel and compelling support for using brief online surveys for decreasing health-risk behaviors such as sunbed use. Such measures are extremely cost-effective and easy to disseminate and implement. Replication and extension of these findings are warranted.

76 FR 74113 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

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Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

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Unplanned Complex Suicide-A Consideration of Multiple Methods.

PubMed

Ateriya, Navneet; Kanchan, Tanuj; Shekhawat, Raghvendra Singh; Setia, Puneet; Saraf, Ashish

2018-05-01

Detailed death investigations are mandatory to find out the exact cause and manner in non-natural deaths. In this reference, use of multiple methods in suicide poses a challenge for the investigators especially when the choice of methods to cause death is unplanned. There is an increased likelihood that doubts of homicide are raised in cases of unplanned complex suicides. A case of complex suicide is reported where the victim resorted to multiple methods to end his life, and what appeared to be an unplanned variant based on the death scene investigations. A meticulous crime scene examination, interviews of the victim's relatives and other witnesses, and a thorough autopsy are warranted to conclude on the cause and manner of death in all such cases. © 2017 American Academy of Forensic Sciences.

First record of Pulvinaria urbicola Cockerell (Hemiptera: Coccidae) from India, with a key to the Indian species of Pulvinaria Targioni Tozzetti.

PubMed

Joshi, Sunil

2017-02-23

The notoriously destructive and invasive soft scale, Pulvinaria urbicola Cockerell (Hemiptera: Coccidae), is recorded for the first time from India. This scale, with variable morphological appearance and similarities with other known scales of the same genus established in India, is redescribed to facilitate its identification and separation from other similar species. Information on its host range, natural enemies and distribution is provided. Management options in the event of an outbreak are discussed briefly. A key to the species of Pulvinaria Targioni Tozzetti in India is also provided. This new arrival warrants special attention in India as it is a potentially damaging plant pest and has a broad host range across many plant families.

Control of hepatocyte metabolism by sympathetic and parasympathetic hepatic nerves.

PubMed

Püschel, Gerhard P

2004-09-01

More than any other organ, the liver contributes to maintaining metabolic equilibrium of the body, most importantly of glucose homeostasis. It can store or release large quantities of glucose according to changing demands. This homeostasis is controlled by circulating hormones and direct innervation of the liver by autonomous hepatic nerves. Sympathetic hepatic nerves can increase hepatic glucose output; they appear, however, to contribute little to the stimulation of hepatic glucose output under physiological conditions. Parasympathetic hepatic nerves potentiate the insulin-dependent hepatic glucose extraction when a portal glucose sensor detects prandial glucose delivery from the gut. In addition, they might coordinate the hepatic and extrahepatic glucose utilization to prevent hypoglycemia and, at the same time, warrant efficient disposal of excess glucose. Copyright 2004 Wiley-Liss, Inc.

Microsurgical techniques in temporal lobe epilepsy.

PubMed

Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

2017-04-01

Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Sound Generation by Aircraft Wake Vortices

NASA Technical Reports Server (NTRS)

Hardin, Jay C.; Wang, Frank Y.

2003-01-01

This report provides an extensive analysis of potential wake vortex noise sources that might be utilized to aid in their tracking. Several possible mechanisms of aircraft vortex sound generation are examined on the basis of discrete vortex dynamic models and characteristic acoustic signatures calculated by application of vortex sound theory. It is shown that the most robust mechanisms result in very low frequency infrasound. An instability of the vortex core structure is discussed and shown to be a possible mechanism for generating higher frequency sound bordering the audible frequency range. However, the frequencies produced are still low and cannot explain the reasonably high-pitched sound that has occasionally been observed experimentally. Since the robust mechanisms appear to generate only very low frequency sound, infrasonic tracking of the vortices may be warranted.

Carcinoma of penis. Review of cases treated by surgery and radiation therapy 1960-1977

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krieg, R.M.; Luk, K.H.

1981-08-01

Cases of squamous cell carcinoma of the penis treated by surgery and radiation therapy at Moffitt Hospital, University of California, and Mount Zion Hospital and Medical Center are reviewed. Only cases followed for more than three years or with autopsy findings are presented. For the primary lesion, over-all surgical control rate locally was 15/17 or 88 per cent. Over-all control rate with radiation therapy alone was 9/12 (75 per cent), and with surgical salvage 11/12 (92 per cent). Radiation therapy appears to be the treatment of choice for early stage lesions, reserving surgery for salvage. Prophylactic ilioinguinal lymph node dissectionmore » for N0 lesions is not warranted. The role of chemotherapy needs further investigation.« less

Is the shortened dental arch still a satisfactory option?

PubMed

Manola, M; Hussain, F; Millar, B J

2017-07-21

Aims Dental practitioners may hold the view that missing posterior teeth should be replaced to ensure a healthy masticatory system and satisfactory oral function. However, the shortened dental arch (SDA) concept is still in use, but after 35 years is it acceptable? This review searches the literature for the evidence and opinions regarding the suitability of the SDA as a current treatment modality.Methods Medline and PubMed databases were searched for relevant terms, all the abstracts were assessed and articles selected according to the pre-set exclusion and inclusion criteria.Results The search yielded 1,895 articles and after the assessment of the abstracts and application of the exclusion and inclusion criteria, 44 articles were selected for this review. These included 11 cohort studies, two longitudinal studies, two animal studies, three cross sectional studies, eight clinical studies and 18 case control studies. There appears to be a trend over the past three decades for more papers to be opposed to the SDA concept.Conclusion Evidence that the SDA causes pathology is lacking. Clinicians, healthcare authorities and patients have shown favourable attitudes towards the SDA and this continues, although there is an increase in studies opposing the concept and some are dissatisfied with this option. The concept remains viable particularly for the medically compromised patient or where restorations are considered unsuitable but further more specific studies are warranted.

Adjuvant bisphosphonate treatment for breast cancer: why did something so elegant become so complicated?

PubMed

Clemons, Mark; Russell, Kent; Costa, Luis; Addison, Christina L

2012-07-01

Bisphosphonate therapy has revolutionized the care of patients with metastatic bone disease. With its demonstrated activity and anti-tumour effects in preclinical studies it was natural to transition these agents to testing in the adjuvant setting. Surprisingly, the results of adjuvant breast cancer trials have shown either modest or no benefit or even harm. We sought to explore whether there were specific patient cohorts or treatment strategies that were most likely to benefit from adjuvant bisphosphonate therapy. We compared trial designs, patient characteristics and outcomes from the six published and two presented randomized adjuvant bisphosphonate trials. Differences in trial design and patient populations make direct comparisons complicated. The most efficacious use of adjuvant bisphosphonates appears to be in patients with either biopsy evidence of osseous micrometastases, were post-menopausal or had estrogen receptor-positive tumours. Despite tremendous optimism regarding adjuvant bisphosphonate therapy, results from large trials are conflicting. Further investigation into factors influencing response to bisphosphonate treatment or selection of appropriate sub-groups of patients with desirable response characteristics is warranted.

Evaluation of the public health risks associated with semivolatile metal and dioxin emissions from hazardous waste incinerators.

PubMed Central

Sedman, R M; Esparza, J R

1991-01-01

The public health impacts associated with stack emissions from hazardous waste incinerators have become a major concern in recent years. Most evaluations of incinerator stack emissions have focused on three classes of compounds: metals, semivolatile, and volatile compounds. These investigations have been complicated by the difficulty and expense of analyzing the emissions and the limited amount of toxicity information for many of the compounds that have been detected. The results of over 20 trial burns at hazardous waste incinerators were assembled in an attempt to determine which compounds may pose a significant threat to the public health. The risks associated with semivolatile emissions were found to be inconsequential, although further study of dioxins and dibenzofurans emissions appears to be warranted. The risk associated with the emission of cadmium and perhaps chromium (VI) may pose a significant risk to public health at certain facilities. Controls on waste feed or air pollution control devices should be employed to reduce the emission of these metals. Any monitoring of metal emissions from hazardous waste incinerators should focus on cadmium and chromium (VI). PMID:1954929

Efficacy of dacarbazine as a rescue agent for histiocytic sarcoma in dogs.

PubMed

Kezer, K A; Barber, L G; Jennings, S H

2018-03-01

Canine histiocytic sarcoma (HS) is an aggressive neoplasm that is generally associated with a poor prognosis. CCNU is considered first-line medical therapy, although the majority of dogs ultimately develop progressive disease. The objective of this study was to evaluate the efficacy of dacarbazine as a rescue agent for HS. Medical records of dogs diagnosed with HS that received at least one dose of dacarbazine were reviewed. Information collected and analyzed included signalment, disease distribution, treatment history, dacarbazine treatments (including dose, interval and total number of cycles), adverse events, and response to treatment. Seventeen dogs were included, all of which had disseminated or metastatic disease and had received prior treatment with CCNU. Three dogs achieved partial remission for an overall response rate of 17.6%. The overall median event-free survival (EFS) was 21 days. For dogs that experienced an objective response, the EFS was 70 days. Toxicity secondary to dacarbazine was generally mild and self-limiting. In the setting of advanced disease, dacarbazine appears to have modest activity against HS and warrants further investigation. © 2017 John Wiley & Sons Ltd.

An alternative animal protein source: cultured beef.

PubMed

Post, Mark J

2014-11-01

Alternative sources of animal proteins are needed that can be produced efficiently, thereby providing food security with diminished ecological burden. It is feasible to culture beef from bovine skeletal muscle stem cells, but the technology is still under development. The aim is to create a beef mimic with equivalent taste, texture, and appearance and with the same nutritional value as livestock-produced beef. More specifically, there is a need for optimization of protein content and fat content. In addition, scalability of production requires modification of current small-scale bioreactors to the largest possible scale. The necessary steps and current progress suggest that this aim is achievable, but formal evidence is still required. Similarly, we can be optimistic about consumer acceptance based on initial data, but detailed studies are needed to gain more insight into potential psychological obstacles that could lead to rejection. These challenges are formidable but likely surmountable. The severity of upcoming food-security threats warrants serious research and development efforts to address the challenges that come with bringing cultured beef to the market. © 2014 New York Academy of Sciences.

Concurrent Improvement in Both Binge Eating and Depressive Symptoms with Naltrexone/Bupropion Therapy in Overweight or Obese Subjects with Major Depressive Disorder in an Open-Label, Uncontrolled Study.

PubMed

Guerdjikova, Anna I; Walsh, Brandon; Shan, Kevin; Halseth, Amy E; Dunayevich, Eduardo; McElroy, Susan L

2017-10-01

Binge eating disorder (BED) is associated with obesity and major depressive disorder (MDD). Naltrexone extended-release (ER)/bupropion ER (NB) is approved as an adjunct to diet and physical activity for chronic weight management. In a prospectively designed 24-week open-label, single-arm, single-site trial of 25 women with MDD and overweight/obesity, NB reduced weight and depressive symptoms. This post hoc analysis investigated the relationship between change in self-reported binge eating behavior (evaluated with the Binge Eating Scale [BES]) and changes in weight, control of eating, and depressive symptoms. At baseline, 91% of subjects had moderate or severe BES scores, suggesting BED. BES scores were significantly improved from week 4, and by week 24, 83% reported "little or no problem." Improvement in BES scores correlated with improvement in depressive symptoms and control of eating. NB may be effective in reducing binge eating symptoms associated with MDD and overweight/obesity. Evaluation of NB in BED appears warranted. Orexigen Therapeutics, Inc.

Inflammatory nodules following soft tissue filler use: a review of causative agents, pathology and treatment options.

PubMed

Ledon, Jennifer A; Savas, Jessica A; Yang, Steven; Franca, Katlein; Camacho, Ivan; Nouri, Keyvan

2013-10-01

Nodule development is a common complication following the use of fillers for soft tissue augmentation and is commonly categorized as inflammatory or non-inflammatory in nature. Inflammatory nodules may appear anywhere from days to years after treatment, whereas non-inflammatory nodules are typically seen immediately following implantation and are usually secondary to improper placement of the filler. Although inflammatory nodules are more common with permanent fillers such as silicone, inflammatory nodule development following administration of temporary fillers such as hyaluronic acid and collagen has also been reported. Treated many times with corticosteroids due to their anti-inflammatory properties, inflammatory nodules may be secondary to infection or biofilm formation, warranting the use of alternative agents. Appropriate and prompt diagnosis is important in avoiding delay of treatment or long-term complications for the patient. This paper addresses the etiology, development, and studied treatment options available for inflammatory nodules secondary to each of the major classes of fillers. With this knowledge, practitioners may expeditiously recognize and manage this common side effect and thus maximize functional and aesthetic benefit.

Animal models of post-ischemic forced use rehabilitation: methods, considerations, and limitations

PubMed Central

2013-01-01

Many survivors of stroke experience arm impairments, which can severely impact their quality of life. Forcing use of the impaired arm appears to improve functional recovery in post-stroke hemiplegic patients, however the mechanisms underlying improved recovery remain unclear. Animal models of post-stroke rehabilitation could prove critical to investigating such mechanisms, however modeling forced use in animals has proven challenging. Potential problems associated with reported experimental models include variability between stroke methods, rehabilitation paradigms, and reported outcome measures. Herein, we provide an overview of commonly used stroke models, including advantages and disadvantages of each with respect to studying rehabilitation. We then review various forced use rehabilitation paradigms, and highlight potential difficulties and translational problems. Lastly, we discuss the variety of functional outcome measures described by experimental researchers. To conclude, we outline ongoing challenges faced by researchers, and the importance of translational communication. Many stroke patients rely critically on rehabilitation of post-stroke impairments, and continued effort toward progression of rehabilitative techniques is warranted to ensure best possible treatment of the devastating effects of stroke. PMID:23343500

Pimecrolimus 1% cream for anogenital lichen sclerosus in childhood

PubMed Central

Boms, Stefanie; Gambichler, Thilo; Freitag, Marcus; Altmeyer, Peter; Kreuter, Alexander

2004-01-01

Background Lichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region. Because of the potential side effects of repeated local application of potent glucocorticosteroids, equally-effective, safer therapeutic options are required, especially in the treatment of children. Case presentations We report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. After three to four-month treatment, all patients had almost complete clinical remission including relief from itch, pain and inflammation. Only minor improvement was observed for the white sclerotic lesions. No significant side effects have been observed. Conclusions Topical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. The clinical benefits observed in the four patient presented particularly include relief of pruritus, pain and inflammation. Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus. PMID:15485581

Partial clinical response to anakinra in severe palmoplantar pustular psoriasis.

PubMed

Tauber, M; Viguier, M; Alimova, E; Petit, A; Lioté, F; Smahi, A; Bachelez, H

2014-09-01

Palmoplantar pustular psoriasis is a clinical psoriasis variant characterised by a high impact on quality of life and poor response to biologics approved for plaque type psoriasis.The recombinant interleukin-1 (IL-1) receptor antagonist anakinra has been recently used for the treatment of isolated refractory cases of generalised pustular psoriasis with contrasted results. To report the clinical response in two patients treated with anakinra as salvage therapy in two patients with severe palmoplantar pustular psoriasis refractory to currently available antipsoriatic systemic therapies. Anakinra was given subcutaneously at the daily dose of 100 mg, and clinical response was evaluated using the palmoplantar psoriasis area and severity index (PPPASI). Only partial and transient responses were observed in both patients, who had to stop anakinra due to lack of efficacy and to side effects. Anakinra appears to provide only partial clinical improvement in refractory palmoplantar pustular psoriasis. Prospective clinical studies on larger populations are warranted to investigate more accurately both efficacy and safety of IL-1-inhibiting strategies in pustular psoriasis. © 2014 British Association of Dermatologists.

Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period.

PubMed

Marín-Morales, Dolores; Toro-Molina, Susana; Peñacoba-Puente, Cecilia; Losa-Iglesias, Marta; Carmona-Monge, Francisco Javier

2018-06-01

Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.

Changes in Withdrawal and Craving Scores in Participants Undergoing Opioid Detoxification Utilizing Ibogaine.

PubMed

Malcolm, Benjamin J; Polanco, Martin; Barsuglia, Joseph P

2018-04-02

Opioid use disorder (OUD) is currently an epidemic in the United States (US) and ibogaine is reported to have the ability to interrupt opioid addiction by simultaneously mitigating withdrawal and craving symptoms. This study examined opioid withdrawal and drug craving scores in 50 participants with OUD undergoing a week-long detoxification treatment protocol with ibogaine. The Addiction Severity Index (ASI) was used for baseline characterization of participants' OUD. Clinical Opioid Withdrawal Scale (COWS), Subjective Opioid Withdrawal Scale (SOWS), and Brief Substance Craving Scale (BSCS) scores were collected at 48 and 24 hours prior to ibogaine administration, as well as 24 and 48 hours after ibogaine administration. At 48 hours following ibogaine administration, withdrawal and craving scores were significantly lowered in comparison to baseline: 78% of patients did not exhibit objective clinical signs of opioid withdrawal, 79% reported minimal cravings for opioids, and 68% reported subjective withdrawal symptoms in the mild range. Ibogaine appears to facilitate opioid detoxification by reducing opioid withdrawal and craving in participants with OUD. These results warrant further research using rigorous controlled trials.

I’m not just fat, I’m old: has the study of body image overlooked “old talk”?

PubMed Central

2013-01-01

Background Research indicates that body dissatisfaction is correlated with and often predictive of both physical and mental health problems. “Fat talk,” a well-studied form of body image talk in adolescents and university-aged women, has been implicated as contributing to body dissatisfaction and mediating the relationship between body dissatisfaction and other mental health problems. Limited research, however, has investigated fat talk across the female lifespan. Further, consistent with most body image research, fat talk research solely focuses on the thin dimension of idealized female attractiveness, even though other dimensions may contribute to body dissatisfaction in women. Method The current study investigated whether or not “old talk,” a hereto un-described form of body image talk, appears to be a parallel, but distinct, form of body image talk that taps into the young dimension of the thin-young-ideal standard of female beauty. An international, internet sample of women (aged 18-87, N = 914) completed questionnaires aimed at assessing fat talk, old talk, body image disturbance, and eating disorder pathology. Results Results indicated that both fat talk and old talk were reported by women across the lifespan, although they evidenced different trajectories of frequency. Like fat talk, old talk was significantly correlated with body image disturbance and eating disorder pathology, albeit at a lower rate than fat talk in the total sample. Old talk was more highly correlated with ageing appearance anxiety than fat talk, and the correlation between old talk and body image disturbance and ED pathology increased with women’s ages. Conclusion Results suggest that old talk is a form of body image talk that is related to but distinct from fat talk. Old talk appears to be similarly problematic to fat talk for women whose age increases their deviation from the thin-young-ideal. Further research into the phenomenon of old talk is warranted as is increased attention to fat talk across the full lifespan of women. PMID:24764529

Feasibility, safety, and effectiveness of transcranial direct current stimulation for decreasing post-ERCP pain: a randomized, sham-controlled, pilot study.

PubMed

Borckardt, Jeffrey J; Romagnuolo, Joseph; Reeves, Scott T; Madan, Alok; Frohman, Heather; Beam, Will; George, Mark S

2011-06-01

Emerging evidence shows that transcranial direct current stimulation (tDCS), a minimally invasive brain stimulation technique, has analgesic effects in chronic pain patients and in healthy volunteers with experimental pain. No studies have examined the analgesic effects of tDCS immediately after surgical/endoscopic procedures. Endoscopy investigating abdominal pain, especially ERCP, can cause significant postprocedural pain. To test the feasibility, efficacy, and safety of tDCS on post-ERCP pain and analgesia use. Randomized, sham-controlled, pilot study. Tertiary-care medical center. This study involved 21 patients who were hospitalized overnight for ERCP for unexplained right upper quadrant pain. Twenty minutes of real 2.0 mA tDCS or sham (anode over left prefrontal cortex; cathode over gut-representation of right sensory cortex) immediately after ERCP. Pain (visual analogue scale, McGill pain questionnaire, brief pain inventory), patient-controlled analgesia use, adverse events. Real tDCS was associated with 22% less total hydromorphone use, versus sham. The slope of the cumulative patient-controlled analgesia usage curve was significantly steeper in the sham tDCS group (F [2,13] = 15.96; P = .0003). Real tDCS patients reported significantly less pain interference with sleep (t [17] = 3.70; P = .002) and less throbbing pain (t [16] = 2.37; P = .03). Visual analogue scale pain and mood scores (4 hours post-ERCP) suggested a nonsignificant advantage for real tDCS, despite less hydromorphone use. Side effects of tDCS were limited to mild, self-limited tingling, itching, and stinging under electrodes. Small sample size, variability in chronic pain, and chronic opioid use. In this pilot study, tDCS appears to be safe, has minimal side effects, and may reduce postprocedural analgesia requirements and subjective pain ratings. Future studies appear warranted. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

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Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth.

PubMed

Rojas, Joselyn; Chávez, Mervin; Olivar, Luis; Rojas, Milagros; Morillo, Jessenia; Mejías, José; Calvo, María; Bermúdez, Valmore

2014-01-01

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.

Differences in the clinical characteristics of adolescent depressive disorders.

PubMed

Karlsson, Linnea; Pelkonen, Mirjami; Heilä, Hannele; Holi, Matti; Kiviruusu, Olli; Tuisku, Virpi; Ruuttu, Titta; Marttunen, Mauri

2007-01-01

Our objective was to analyze differences in clinical characteristics and comorbidity between different types of adolescent depressive disorders. A sample of 218 consecutive adolescent (ages 13-19 years) psychiatric outpatients with depressive disorders was interviewed for DSM-IV Axis I and Axis II diagnoses. We obtained data by interviewing the adolescents themselves and collecting additional background information from the clinical records. Lifetime age of onset for depression, current episode duration, frequency of suicidal behavior, psychosocial impairment, and the number of current comorbid psychiatric disorders varied between adolescent depressive disorder categories. The type of co-occurring disorder was mainly consistent across depressive disorders. Minor depression and dysthymia (DY) presented as milder depressions, whereas bipolar depression (BPD) and double depression [DD; i.e., DY with superimposed major depressive disorder (MDD)] appeared as especially severe conditions. Only earlier lifetime onset distinguished recurrent MDD from first-episode MDD, and newly emergent MDD appeared to be as impairing as recurrent MDD. Adolescent depressive disorder categories differ in many clinically relevant aspects, with most differences reflecting a continuum of depression severity. Identification of bipolarity and the subgroup with DD seems especially warranted. First episode MDD should be considered as severe a disorder as recurring MDD. (c) 2006 Wiley-Liss, Inc.

Immune-mediated extrapyramidal movement disorders, including Sydenham chorea.

PubMed

Dale, Russell C

2013-01-01

Immune-mediated extrapyramidal movement disorders typically occur in previously healthy children. Immune-mediated movement disorders may occur as a postinfectious, paraneoplastic, or idiopathic process. Sydenham chorea (SC) is the classical poststreptococcal movement and psychiatric disorder, and may be associated with other features of rheumatic fever. The outcome is typically good, although residual chorea, psychiatric disturbance, and relapses are possible. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is a syndrome of streptococcal-induced tics and obsessive-compulsive disorder. Although a number of investigators have reported an association between streptococcal infection and neuropsychiatric syndromes, the PANDAS hypothesis is controversial. Encephalitis lethargica is an encephalitic illness with parkinsonism, dyskinesias, and psychiatric disturbance as dominant features. The exact disease mechanism is not understood, although an autoimmune process is suspected. NMDA-R encephalitis is a new entity characterized by encephalitis with dramatic psychiatric disturbance, dyskinesias, cognitive alteration, and seizures. Patients have autoantibodies against the NMDA-R that appear to be pathogenic: immune therapies appear warranted to minimize disability. Movement disorders are also described associated with systemic lupus erythematosus and antiphospholipid syndrome. The differential diagnosis and investigation approach of acute-onset movement disorders are also discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

The Complicated Relationship Between Attention Deficit/Hyperactivity Disorder and Substance Use Disorders

PubMed Central

Zulauf, Courtney A.; Sprich, Susan E.; Safren, Steven A.

2015-01-01

Adolescents and young adults with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) are increasingly presenting in clinical practice. The overlap and role of treatment for these co-occurring disorders remains unclear. A review of the literature was conducted to highlight and update recent evidence on the overlap of ADHD and SUD, the role of ADHD medication on later SUD, and the treatment of ADHD and SUD in adolescents and young adults. Recent work continues to highlight the high risk for comorbid ADHD in patients with SUD; and conversely, the high risk for SUD developing in ADHD across the lifespan, particularly in the context of comorbid conduct disorder. Although the data remains discordant, it appears that ADHD pharmacotherapy does not increase the risk for SUD. Medication treatment alone does not appear to be particularly effective in treating SUD in currently active substance abusing individuals with ADHD. Structured therapies may be effective in treating adolescents and young adults with ADHD and SUD. Further controlled trials evaluating the sequence and effect of structured psychotherapies and/or ADHD pharmacotherapy on SUD relapse in these groups are warranted. PMID:24526271

Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth

PubMed Central

Rojas, Joselyn; Chávez, Mervin; Olivar, Luis; Rojas, Milagros; Morillo, Jessenia; Mejías, José; Calvo, María; Bermúdez, Valmore

2014-01-01

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome. PMID:25763405

Future Tense and Economic Decisions: Controlling for Cultural Evolution

PubMed Central

Roberts, Seán G.; Winters, James; Chen, Keith

2015-01-01

A previous study by Chen demonstrates a correlation between languages that grammatically mark future events and their speakers' propensity to save, even after controlling for numerous economic and demographic factors. The implication is that languages which grammatically distinguish the present and the future may bias their speakers to distinguish them psychologically, leading to less future-oriented decision making. However, Chen's original analysis assumed languages are independent. This neglects the fact that languages are related, causing correlations to appear stronger than is warranted (Galton's problem). In this paper, we test the robustness of Chen's correlations to corrections for the geographic and historical relatedness of languages. While the question seems simple, the answer is complex. In general, the statistical correlation between the two variables is weaker when controlling for relatedness. When applying the strictest tests for relatedness, and when data is not aggregated across individuals, the correlation is not significant. However, the correlation did remain reasonably robust under a number of tests. We argue that any claims of synchronic patterns between cultural variables should be tested for spurious correlations, with the kinds of approaches used in this paper. However, experiments or case-studies would be more fruitful avenues for future research on this specific topic, rather than further large-scale cross-cultural correlational studies. PMID:26186527

Rationale for the development and the mechanism of action of endoscopic thermal vapor ablation (InterVapor) for the treatment of emphysema.

PubMed

Kesten, Steven; Anderson, Joseph C; Tuck, Stephanie A

2012-07-01

Emphysema remains a disabling disease despite current treatment. Novel approaches to the underlying physiological abnormalities responsible for symptom generation are warranted. A review of current hypotheses and preclinical and clinical data on the utility of endoscopic thermal vapor ablation (InterVapor) in the treatment of emphysema. In animal studies, thermal energy in the form of heated water vapor both in healthy and in papain-induced emphysema in dogs and sheep leads to an inflammatory response followed by healing with airway and parenchymal fibrosis. The fibrosis and associated distal atelectasis result in volume reduction. The amount of thermal energy delivered has been based on the amount of target tissue mass determined from a high-resolution computed tomogram. Early human studies indicated the feasibility of InterVapor with 5 cal/g tissue; however, the dose appeared insufficient to induce lobar volume reduction. A study using 10 cal/g to 1 upper lobe (n=44) induced a mean of 46% lobar volume reduction at 12 months along with significant improvements in the physiology and health outcomes. InterVapor induces lung volume reduction in patients with emphysema. The mechanism of action is through a thermally induced inflammatory response followed by healing with subsequent remodeling of tissue (fibrosis and distal atelectasis).

Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Levine, E.; Huntrakoon, M.; Wetzel, L.H.

Malignant peripheral nerve-sheath neoplasms frequently complicate neurofibromatosis causing pain, enlarging masses, or neurologic deficits. However, similar findings sometimes also occur with benign nerve neoplasms. Our study was done retrospectively to determine if imaging techniques can differentiate malignant from benign nerve tumors in neurofibromatosis. Eight patients with symptomatic neoplasms (three benign, five malignant) were studied by CT in eight, MR in six, and /sup 67/Ga-citrate scintigraphy in seven. Uptake of /sup 67/Ga occurred in all five malignant lesions but not in two benign neoplasms studied. On CT or MR, all eight lesions, including three benign neoplasms, showed inhomogeneities. Of five lesionsmore » with irregular, infiltrative margins on CT or MR, four were malignant and one was benign. Of three lesions with smooth margins, one was malignant and two were benign. One malignant neoplasm caused irregular bone destruction. Accordingly, CT and MR could not generally distinguish malignant from benign lesions with certainty. However, both CT and MR provided structural delineation to help surgical planning for both types of lesion. /sup 67/Ga scintigraphy appears promising as a screening technique to identify lesions with malignant degeneration in patients with neurofibromatosis. Any area of abnormal radiogallium uptake suggests malignancy warranting further evaluation by CT or MR. Biopsy of any questionable lesion is essential.« less

Do familiar teammates request and accept more backup? Transactive memory in air traffic control.

PubMed

Smith-Jentsch, Kimberly A; Kraiger, Kurt; Cannon-Bowers, Janis A; Salas, Eduardo

2009-04-01

The present study investigated factors that explain when and why different groups of teammates are more likely to request and accept backup from one another when needed in an environment characterized by extreme time pressure and severe consequences of error: commercial air traffic control (ATC). Transactive memory theory states that teammates develop consensus regarding the distribution of their relative expertise as well as confidence in that expertise over time and that this facilitates coordination processes. The present study investigated whether this theory could help to explain between-team differences in requesting and accepting backup when needed. The present study used cross-sectional data collected from 51 commercial ATC teams. Hypotheses were tested using multiple regression analysis. Teammates with greater experience working together requested and accepted backup from one another more than those with lesser experience working together. Teammate knowledge consensus and perceived team efficacy appear to have mediated this relationship. Transactive memory theory extends to high-stress environments in which members' expertise is highly overlapping. Teammates' shared mental models about one another increase the likelihood that they will request and accept backup. Teammate familiarity should be considered when choosing among potential replacement team members. Training strategies that accelerate the development of teammate knowledge consensus and team efficacy are warranted.

Dietary Intake, Body Composition, and Menstrual Cycle Changes during Competition Preparation and Recovery in a Drug-Free Figure Competitor: A Case Study

PubMed Central

Halliday, Tanya M.; Loenneke, Jeremy P.; Davy, Brenda M.

2016-01-01

Physique competitions are events in which competitors are judged on muscular appearance and symmetry. The purpose of this retrospective case study was to describe changes in dietary intake, body mass/composition, and the menstrual cycle during the 20-week competition preparation (PREP) and 20-week post competition recovery (REC) periods of a drug-free amateur female figure competitor (age = 26–27, BMI = 19.5 kg/m2). Dietary intake (via weighed food records) and body mass were assessed daily and averaged weekly. Body composition was estimated via Dual-energy X-ray absorptiometry (DXA) and 7-site skinfold measurements. Energy intake, body mass and composition, and energy availability decreased during the 20-week PREP period (changes of ~298 kcals, 5.1 kg, 6.5% body fat, and 5.4 kcal/kg fat free mass, respectively) and returned to baseline values by end of the 20-week REC period. Menstrual cycle irregularity was reported within the first month of PREP and the last menstruation was reported at week 11 of PREP. Given the potentially adverse health outcomes associated with caloric restriction, future, prospective cohort studies on the physiological response to PREP and REC are warranted in drug-free, female physique competitors. PMID:27879627

Treatment of refractory sino-nasal aspergillosis with posaconazole and terbinafine in 10 dogs.

PubMed

Stewart, J; Bianco, D

2017-09-01

To determine the safety and efficacy of posaconazole and terbinafine for the treatment of naturally occurring sino-nasal aspergillosis in dogs refractory to conventional topical and systemic treatment. Ten client-owned dogs with sino-nasal aspergillosis and not responsive to conventional treatments were prospectively enrolled to receive a dose of 5 mg/kg posaconazole orally every 12 hours for six months. All dogs were concurrently treated with doses of 30 mg/kg terbinafine orally every 12 hours and 5 mg/kg doxycycline orally every 12 hours for 6 to 18 months. All 10 enrolled dogs completed the study. The treatment response was defined as complete clinical remission (n=7) or partial clinical remission (n=3). Two dogs relapsed after cessation of combination therapy. All dogs lived more than one year after starting combination therapy and eight dogs are alive at the time of writing. No clinically relevant adverse reactions or increases in hepatic enzyme activity occurred during the combination therapy. The results of this study suggest that this combination therapy appears safe and well-tolerated for the treatment of refractory sino-nasal aspergillosis in dogs. Long-term survival is possible with prolonged treatment, but relapse is possible. Larger prospective studies are warranted to further evaluate these preliminary findings. © 2017 British Small Animal Veterinary Association.

Effects of Intranasal Oxytocin on Long-Term Memory in Healthy Humans: A Systematic Review.

PubMed

Brambilla, Michela; Manenti, Rosa; de Girolamo, Giovanni; Adenzato, Mauro; Bocchio-Chiavetto, Luisella; Cotelli, Maria

2016-12-01

Preclinical Research The neuropeptide oxytocin (Oxt) is implicated in complex emotional and social behaviors and appears to play an important role in learning and memory. Animal studies have shown that the effects of exogenous Oxt on memory vary according to the timing of administration, context, gender, and dose and may improve the memory of social, but not nonsocial stimuli. Oxt is intimately involved in a broad array of neuropsychiatric functions and may therefore be a pharmacological target for several psychiatric disorders. This review summarizes the potential effects of Oxt on long-term memory processes in healthy humans based on a PubMed search over the period 1980-2016. The effects of intranasal Oxt on human memory are controversial and the studies included in this review have applied a variety of learning paradigms, in turn producing variable outcomes. Specifically, data on the long-term memory of nonemotional stimuli found no effect or even worsening in memory, while studies using emotional stimuli showed an improvement of long-term memory performance. In conclusion, this review identified a link between long-term memory performance and exogenous intranasal Oxt in humans, although these results still warrant further confirmation in large, multicenter randomized controlled trials. Drug Dev Res 77 : 479-488, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Oligoclonal bands in multiple sclerosis reactive against two herpesviruses and association with magnetic resonance imaging findings

PubMed Central

Virtanen, JO; Wohler, J; Fenton, K; Reich, DS; Jacobson, S

2016-01-01

Background Two human herpesviruses, human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV), have been repeatedly linked to multiple sclerosis (MS). Objective The aim of this study was to investigate HHV-6 and EBV reactive oligoclonal bands (OCBs), and viral DNA in the intrathecal compartment in MS. Methods The reactivity of OCBs in cerebrospinal fluid (CSF) for EBV and HHV-6 antigens and stability of virus reactive OCBs over time were studied in a well-characterized MS patient cohort. Associations between virus reactive OCBs and viral DNA in CSF (and any clinical and/or radiological findings) were investigated. Results Of patients with MS, 38% had OCBs reactive to either one of the viruses studied, compared to none in the patients with other inflammatory neurological diseases (p=0.005). The banding pattern of virus reactive OCBs remained the same over time. Furthermore, MS patients with viral DNA in CSF had more contrast enhancing lesions (CELs). Conclusion The stable presence of herpesvirus reactive OCBs in CSF further strengthens the association of MS with these viruses. The finding that herpesviruses might be linked to the appearance of active lesions warrants investigation of new therapeutic strategies to treat these viruses in MS. PMID:23722324

The reliability and validity of the Greenspan Social Emotional Growth Chart (GSEGC) in Israeli children with developmental delay and autism-A pilot study.

PubMed

Tede, Zoma; Ophir Cohen, Michal; Riskin, Arieh; Tirosh, Emanuel

2016-08-01

Healthy social-emotional development in early childhood is important as an indicator of general well-being and for positive outcome in later childhood. Therefore, screening for potential social emotional problems is valuable. Accurate, usable, and affordable screening tools have been especially difficult to develop. The cross cultural validity of a screening instrument should be assessed. The aim of the current study was to investigate the reliability and validity of the Greenspan social-emotional growth chart (GSEGC) in Israeli children of three diagnostic groups: (1) Autistic spectrum disorder (ASD) (2) Developmental language disorder (DLD) and (3) Developmental motor delay (DMD). An internal reliability of alpha of 0.95 for the GSEGC standardized for age score and of 0.78 for the sensory processing sub scores was found. A confirmatory factor analysis (CFA) using a 5-factor model confirmed an acceptable fit. Positive (62.86%) and negative (94.73%) predictive values also support the clinical usefulness of the GSEGC in identifying children at low risk for ASD. The GSEGC appears to be a promising tool for the screening of social emotional problems in early childhood. Further studies in different cultures are warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Future Tense and Economic Decisions: Controlling for Cultural Evolution.

PubMed

Roberts, Seán G; Winters, James; Chen, Keith

2015-01-01

A previous study by Chen demonstrates a correlation between languages that grammatically mark future events and their speakers' propensity to save, even after controlling for numerous economic and demographic factors. The implication is that languages which grammatically distinguish the present and the future may bias their speakers to distinguish them psychologically, leading to less future-oriented decision making. However, Chen's original analysis assumed languages are independent. This neglects the fact that languages are related, causing correlations to appear stronger than is warranted (Galton's problem). In this paper, we test the robustness of Chen's correlations to corrections for the geographic and historical relatedness of languages. While the question seems simple, the answer is complex. In general, the statistical correlation between the two variables is weaker when controlling for relatedness. When applying the strictest tests for relatedness, and when data is not aggregated across individuals, the correlation is not significant. However, the correlation did remain reasonably robust under a number of tests. We argue that any claims of synchronic patterns between cultural variables should be tested for spurious correlations, with the kinds of approaches used in this paper. However, experiments or case-studies would be more fruitful avenues for future research on this specific topic, rather than further large-scale cross-cultural correlational studies.

Cutin from watermelon peels: A novel inducer for cutinase production and its physicochemical characterization.

PubMed

Chaudhari, Sandeep A; Singhal, Rekha S

2015-08-01

Cutin a polymeric biological macromolecule made up of esterified polyacids which acts as an inducer of cutinase. The present work was based on screening and characterization of newer cutin source from the agro industrial wastes as inducers of cutinase production by Fusarium oxysporum MTCC 2480. Cutin isolated from peels of multi green colored watermelon (WMC) yielded 6.77 U/mL as compared to that 9.64 U/mL of cutinase using apple cutin. The FTIR and (13)C CP-MAS solid state NMR studies indicated the nature of WMC to be an aliphatic polyester of polyhydroxy fatty acids. A further FTIR spectroscopic study on dewaxed cutin confirmed that the ester linkages in WMC were completely hydrolyzed during submerged fermentation. GC-MS data clearly indicated the critical structural feature of WMC viz. hydroxyl groups at ω-position and middle of the fatty acid chain. The amorphous nature of WMC was confirmed by XRD. DSC of WMC showed two endothermic transition peaks, one broad appearing at 30-60 °C and other at 145 °C. Thermogravimetric analysis of WMC suggested it to be thermally stable up to 200 °C. This study warrants further work on using WMC as a substrate for fermentative production of cutinase. Copyright © 2015 Elsevier B.V. All rights reserved.

Bioavailability and potential uses of vegetarian sources of omega-3 fatty acids: a review of the literature.

PubMed

Lane, Katie; Derbyshire, Emma; Li, Weili; Brennan, Charles

2014-01-01

Presently alpha-linolenic acid (ALA) is the most widely used vegetarian LC3PUFA, but only marginal amounts are converted into eicosapentaenoic (EPA) and docosahexaenoic acid (DHA); both of which are strongly related to human health. Currently, fish oils represent the most prominent dietary sources of EPA and DHA; however, these are unsuitable for vegetarians. Alternative sources include flaxseed, echium, walnut, and algal oil but their conversion to EPA and DHA must be considered. The present systematic review sets out to collate information from intervention studies examining the bioavailability of alternative vegetarian long chain omega-3 (n-3) polyunsaturated fatty acids (LC3PUFA) sources. Ten key papers published over the last 10 years were identified with seven intervention studies reporting that ALA from nut and seed oils was not converted to DHA at all. Three studies showed that ingestion of micro-algae oil led to significant increases in blood erythrocyte and plasma DHA. Further work is now needed to identify optimal doses of alternative vegetarian LC3PUFAs and how these can be integrated within daily diets. The potential role of algal oils appears to be particularly promising and an area in which further research is warranted.

Detection of Clinical Depression in Adolescents’ Speech During Family Interactions

PubMed Central

Low, Lu-Shih Alex; Maddage, Namunu C.; Lech, Margaret; Sheeber, Lisa B.; Allen, Nicholas B.

2013-01-01

The properties of acoustic speech have previously been investigated as possible cues for depression in adults. However, these studies were restricted to small populations of patients and the speech recordings were made during patients’ clinical interviews or fixed-text reading sessions. Symptoms of depression often first appear during adolescence at a time when the voice is changing, in both males and females, suggesting that specific studies of these phenomena in adolescent populations are warranted. This study investigated acoustic correlates of depression in a large sample of 139 adolescents (68 clinically depressed and 71 controls). Speech recordings were made during naturalistic interactions between adolescents and their parents. Prosodic, cepstral, spectral, and glottal features, as well as features derived from the Teager energy operator (TEO), were tested within a binary classification framework. Strong gender differences in classification accuracy were observed. The TEO-based features clearly outperformed all other features and feature combinations, providing classification accuracy ranging between 81%–87% for males and 72%–79% for females. Close, but slightly less accurate, results were obtained by combining glottal features with prosodic and spectral features (67%–69% for males and 70%–75% for females). These findings indicate the importance of nonlinear mechanisms associated with the glottal flow formation as cues for clinical depression. PMID:21075715

Ciliate communities consistently associated with coral diseases

NASA Astrophysics Data System (ADS)

Sweet, M. J.; Séré, M. G.

2016-07-01

Incidences of coral disease are increasing. Most studies which focus on diseases in these organisms routinely assess variations in bacterial associates. However, other microorganism groups such as viruses, fungi and protozoa are only recently starting to receive attention. This study aimed at assessing the diversity of ciliates associated with coral diseases over a wide geographical range. Here we show that a wide variety of ciliates are associated with all nine coral diseases assessed. Many of these ciliates such as Trochilia petrani and Glauconema trihymene feed on the bacteria which are likely colonizing the bare skeleton exposed by the advancing disease lesion or the necrotic tissue itself. Others such as Pseudokeronopsis and Licnophora macfarlandi are common predators of other protozoans and will be attracted by the increase in other ciliate species to the lesion interface. However, a few ciliate species (namely Varistrombidium kielum, Philaster lucinda, Philaster guamense, a Euplotes sp., a Trachelotractus sp. and a Condylostoma sp.) appear to harbor symbiotic algae, potentially from the coral themselves, a result which may indicate that they play some role in the disease pathology at the very least. Although, from this study alone we are not able to discern what roles any of these ciliates play in disease causation, the consistent presence of such communities with disease lesion interfaces warrants further investigation.

An epidemiologic review of marijuana and cancer: an update

PubMed Central

Huang, Yu-Hui Jenny; Zhang, Zuo-Feng; Tashkin, Donald P.; Feng, Bingjian; Straif, Kurt; Hashibe, Mia

2014-01-01

Marijuana use is legal in two states and additional states are considering legalization. Approximately 18 million Americans are current marijuana users. There is currently no consensus on whether marijuana use is associated with cancer risk. Our objective is to review the epidemiologic studies on this possible association. We identified 34 epidemiologic studies on upper aerodigestive tract cancers (n=11), lung cancer (n=6), testicular cancer (n=3), childhood cancers (n=6), all cancers (n=1), anal cancer (n=1), penile cancer (n=1), non-Hodgkin's lymphoma (n=2), malignant primary gliomas(n=1), bladder cancer (n=1), and Kaposi's sarcoma (n=1). Studies on head and neck cancer reported increased and decreased risks, possibly because there is no association, or because risks differ by HPV status or geographic differences. The lung cancer studies largely appear not to support an association with marijuana use, possibly because of the smaller amounts of marijuana regularly smoked compared to tobacco. Three testicular cancer case-control studies reported increased risks with marijuana use (summary odds ratios 1.56 (95%CI=1.09-2.23) for higher frequency; 1.50 (95%=1.08-2.09) for ≥10 years). For other cancer sites, there is still insufficient data to make any conclusions. Considering that marijuana use may change due to legalization, well-designed studies on marijuana use and cancer are warranted. PMID:25587109

41 CFR 302-6.105 - What is a “compelling reason” warranting extension of my authorized period for claiming an actual...

Code of Federal Regulations, 2014 CFR

2014-07-01

... reasonâ warranting extension of my authorized period for claiming an actual TQSE reimbursement? 302-6.105... is a “compelling reason” warranting extension of my authorized period for claiming an actual TQSE... problems (e.g., delay in settlement on the new residence, or short-term delay in construction of the...

41 CFR 302-6.105 - What is a “compelling reason” warranting extension of my authorized period for claiming an actual...

Code of Federal Regulations, 2013 CFR

2013-07-01

... reasonâ warranting extension of my authorized period for claiming an actual TQSE reimbursement? 302-6.105... is a “compelling reason” warranting extension of my authorized period for claiming an actual TQSE... problems (e.g., delay in settlement on the new residence, or short-term delay in construction of the...

41 CFR 302-6.105 - What is a “compelling reason” warranting extension of my authorized period for claiming an actual...

Code of Federal Regulations, 2011 CFR

2011-07-01

... reasonâ warranting extension of my authorized period for claiming an actual TQSE reimbursement? 302-6.105... is a “compelling reason” warranting extension of my authorized period for claiming an actual TQSE... problems (e.g., delay in settlement on the new residence, or short-term delay in construction of the...

41 CFR 302-6.105 - What is a “compelling reason” warranting extension of my authorized period for claiming an actual...

Code of Federal Regulations, 2010 CFR

2010-07-01

... reasonâ warranting extension of my authorized period for claiming an actual TQSE reimbursement? 302-6.105... is a “compelling reason” warranting extension of my authorized period for claiming an actual TQSE... problems (e.g., delay in settlement on the new residence, or short-term delay in construction of the...

Benefits of an Air Force Contracting Warrant Officer Program

DTIC Science & Technology

2011-12-01

effects of adding the warrant officer track into the contracting career field. The assessment uses personal interviews and surveys covering job...research investigates the perceived benefits and contrasting effects of adding the warrant officer track into the contracting career field. The...centered on cutting costs in the hopes of increasing revenues, which can be disastrous for both the private and public sectors , in addition to the

'It just has to click': Internists' views of: what constitutes productive interactions with chronically ill patients.

PubMed

Kromme, N M H; Ahaus, C T B; Gans, R O B; van de Wiel, H B M

2016-05-27

According to the Chronic Care Model, productive interactions are crucial to patient outcomes. Despite productive interactions being at the heart of the Model, however, it is unclear what constitutes such an interaction. The aim of this study was to gain a better understanding of physician views of productive interactions with the chronically ill. We conducted a qualitative study and interviewed 20 internists working in an academic hospital. The data were analyzed using a constructivist approach of grounded theory. To categorize the data, a coding process within which a code list was developed and tested with two other coders was conducted. The participants engaged in goal-directed reasoning when reflecting on productive interactions. This resulted in the identification of four goal orientations: (a) health outcome; (b) satisfaction; (c) medical process; and (d) collaboration. Collaboration appeared to be conditional for reaching medical process goals and ultimately health outcome and satisfaction goals. Achieving rapport with the patient ('clicking,' in the term of the participants) was found to be a key condition that catalyzed collaboration goals. Clicking appeared to be seen as a somewhat unpredictable phenomenon that might or might not emerge, which one had to accept and work with. Goal orientations were found to be related to the specific medical context (i.e., a participant's subspecialty and the nature of a patient's complaint). The participants viewed a productive interaction as essentially goal-directed, catalyzed by the two parties clicking, and dependent on the nature of a patient's complaint. Using the findings, we developed a conceptual process model with the four goal orientations as wheels and with clicking in the center as a flywheel. Because clicking was viewed as important, but somewhat unpredictable, teaching physicians how to click, while taking account of the medical context, may warrant greater attention.

Status of endangered and threatened plant species on Nevada Test Site: a survey. Part 2. Threatened species

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rhoads, W.A.; Cochrane, S.A.; Williams, M.P.

This is the second of a two-part study of plant species on the Nevada Test Site (NTS) that are listed as possibly threatened or endangered by the U.S. Fish and Wildlife Service (FWS). This study was undertaken as a response by DOE to comply with the Endangered Species Act of 1973 (the Act). Part 1 treated species listed under terms of the Act as proposed endangered species. Part 2 primarily treats those species listed as threatened species candidates. Among the 15 species that grow on NTS and appeared in the Federal Register lists of candidate threatened species we report three:more » Astragalus funereus, Coryphantha vivipara var. rosea, and Gilia ripleyi, that should be considered as threatened. Two other species which occur on NTS and were not included on either the threatened or endangered lists should also be classified as threatened: Penstemon thurberi var. anestius and Sclerocactus polyancistrus. Of the 12 other species originally listed in the Federal Register, eight are of sufficient interest to warrant continued monitoring under a category we suggest as ''Plants of Special Concern.'' The other four do not appear to require any protective measures or surveillance at this time. We suggest critical habitats for those species recommended for threatened status and note that some suggested critical habitats may serve for more than one species and may also include habitats for some species of special concern. Updated information about species covered in Part 1 suggests that Trifolium andersonii var. beatleyae, earlier considered endangered, should now be recommended to be removed from endangered or threatened status because of more widespread distribution than was known to us at the time Part 1 was published.« less

Q fever in Ireland. A seroprevalence study of exposure to Coxiella burnettii among Department of Agriculture workers.

PubMed

Reid, A; Malone, J

2004-12-01

To estimate the risk of exposure to Coxiella burnettii among 'at risk' workers in Ireland. A cross-sectional seroprevalence study, using the complement fixation technique (CFT), was carried out among technical and support staff of the Department of Agriculture in Ireland (n = 375). Participants were divided into low- (n = 34), moderate- (n = 158) and high-risk (n = 83) groups according to the likelihood of occupational exposure. A result of <1:8 on CFT was accepted as normal, i.e. no evidence of past exposure to the causative organism, C. burnettii. Participants with titres of 1:16 were clinically assessed for evidence of past or present infection and interviewed regarding the possibility of non-occupational exposure. The participation rate was 75% (n = 281). Overall, 24 of the 281 participants (8.5%, 95% confidence interval = 5.6-12.4%) tested positive (titres = 1:8). No statistically significant difference existed between the three groups (low, 8.8%; moderate, 9.5%; high, 7.2%). Of those reviewed (n = 10), no evidence of either past or present clinically significant illness was detected. Possible non-occupational exposure was identified in two cases. Laboratory evidence of past exposure to Q fever is common amongst readily identifiable 'at risk' occupational groups in Ireland, and appropriate preventative steps are warranted. Employees who do not have direct exposure to animals or animal products, but who work in a high risk environment appear to have a similar risk of exposure C. burnettii. Although clinical illness appears to be rare, health care workers should consider the possibility of Q fever in cases of unexplained illness arising in those working in 'high risk' environments.

Evolution and loss of long-fringed petals: a case study using a dated phylogeny of the snake gourds, Trichosanthes (Cucurbitaceae)

PubMed Central

2012-01-01

Background The Cucurbitaceae genus Trichosanthes comprises 90–100 species that occur from India to Japan and southeast to Australia and Fiji. Most species have large white or pale yellow petals with conspicuously fringed margins, the fringes sometimes several cm long. Pollination is usually by hawkmoths. Previous molecular data for a small number of species suggested that a monophyletic Trichosanthes might include the Asian genera Gymnopetalum (four species, lacking long petal fringes) and Hodgsonia (two species with petals fringed). Here we test these groups’ relationships using a species sampling of c. 60% and 4759 nucleotides of nuclear and plastid DNA. To infer the time and direction of the geographic expansion of the Trichosanthes clade we employ molecular clock dating and statistical biogeographic reconstruction, and we also address the gain or loss of petal fringes. Results Trichosanthes is monophyletic as long as it includes Gymnopetalum, which itself is polyphyletic. The closest relative of Trichosanthes appears to be the sponge gourds, Luffa, while Hodgsonia is more distantly related. Of six morphology-based sections in Trichosanthes with more than one species, three are supported by the molecular results; two new sections appear warranted. Molecular dating and biogeographic analyses suggest an Oligocene origin of Trichosanthes in Eurasia or East Asia, followed by diversification and spread throughout the Malesian biogeographic region and into the Australian continent. Conclusions Long-fringed corollas evolved independently in Hodgsonia and Trichosanthes, followed by two losses in the latter coincident with shifts to other pollinators but not with long-distance dispersal events. Together with the Caribbean Linnaeosicyos, the Madagascan Ampelosicyos and the tropical African Telfairia, these cucurbit lineages represent an ideal system for more detailed studies of the evolution and function of petal fringes in plant-pollinator mutualisms. PMID:22759528

Gender differences in physiologic markers and health behaviors associated with childhood obesity.

PubMed

Govindan, Morgen; Gurm, Roopa; Mohan, Sathish; Kline-Rogers, Eva; Corriveau, Nicole; Goldberg, Caren; Durussel-Weston, Jean; Eagle, Kim A; Jackson, Elizabeth A

2013-09-01

Previous studies have demonstrated gender-related differences in body composition, physical activity, and diet. This observational study assesses gender variance in independent predictors for obesity to determine targeted areas for intervention. Data from 1714 sixth-grade students enrolled in Project Healthy Schools were compared by using health behaviors and physiologic markers (lipids, random glucose, blood pressure, and resting and recovery heart rates). Students were stratified by gender and obesity (BMI ≥95th percentile by age and gender). Physiologic markers and behaviors were compared by using χ(2) analysis. Univariate associations with P < .10 were included in a stepwise logistic regression model to determine independent predictors for obesity by gender. Nonobese students (both boys and girls) showed significantly healthier physiologic parameters compared with their obese counterparts. Two behaviors independently correlated with obesity in both boys and girls: regularly eating school lunches (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.01-1.64; OR 1.27, 95% CI 1.00-1.62, respectively) and watching ≥2 hours of television per day (OR 1.19, 95% CI 1.07-1.32; OR 1.19, 95% CI 1.06-1.34, respectively). Vigorous physical activity and involvement in school sports teams appeared to be protective against obesity in boys (OR 0.90, 95% CI 0.82-0.98; OR 0.77, 95% CI 0.64-0.94, respectively), whereas milk consumption appeared protective in girls (OR 0.81, 95% CI 0.67-0.98). Among middle-school children, we observed gender-related differences in factors associated with obesity. Additional research is warranted to determine the beneficial impact of improving school lunches and decreasing screen time, while improving our understanding of gender-related differences in milk consumption and physical activities in relation to BMI.

The predictive value of pre-recruitment achievement on resident performance in anesthesiology.

PubMed

Chen, Fei; Arora, Harendra; Martinelli, Susan M; Teeter, Emily; Mayer, David; Zvara, David A; Passannante, Anthony; Smith, Kathleen A

2017-06-01

Selecting candidates for residency positions is challenging and there is little research on the correlation between commonly used selection criteria and subsequent performance in anesthesiology. This study examined the association between the selection measures and post-recruitment performance in residency. Retrospective review of archival data. Anesthesiology residency program at a large academic anesthesiology department. Residents who were matched to the anesthesiology program over 9years (graduation classes of 2006 to 2014). None. The pre-recruitment achievements included a comprehensive list of measures obtained from residents' application portfolios in conjunction with interview performance. The post-recruitment examination outcomes consisted of the in-training examination (ITE) scores in the three clinical anesthesia (CA) years and first-attempt success on the written board certification examination administered by the American Board of Anesthesiology (ABA). Scholarly output during residency was measured by publication record. Clinical performance at the conclusion of residency was independently rated by three faculty members. Bivariate analysis and regression models were conducted to examine association between predictors and outcomes. High United States Medical Licensing Examination (USMLE) scores, class rank in medical school and interview performance were predictive of high examination scores in residency and good clinical performance. Class rank appeared to be the best predictor of scholarly publication and pursuing an academic career beyond residency. Comparative performance with classmates (i.e., class rank) in medical school appeared to be an effective predictor of overall performance in residency, which warrants more attention in future study. Although interview performance is subject to recruitment team members' interpretation, it is an important measure to include in recruitment decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Psychosocial outcomes in a weight loss camp for overweight youth

PubMed Central

QUINLAN, NICOLE P.; KOLOTKIN, RONETTE L.; FUEMMELER, BERNARD F.; COSTANZO, PHILIP R.

2015-01-01

Objective There is good evidence that youth attending weight loss camps in the UK and US are successful at achieving weight loss. Limited research suggests improvement in body image and self-esteem as well. This study evaluated changes in eight psychosocial variables following participation in a weight loss camp and examined the role of gender, age, length of stay, and body mass index (BMI) in these changes. Methods This was an observational and self-report study of 130 participants (mean age=12.8; mean BMI=33.5; 70% female; 77% Caucasian). The program consisted of an 1 800 kcal/day diet, daily supervised physical activities, cooking/nutrition classes, and weekly psycho-educational/support groups led by psychology staff. Participants completed measures of anti-fat attitudes, values (e.g., value placed on appearance, athletic ability, popularity), body- and self-esteem, weight- and health-related quality of life, self-efficacy, and depressive symptoms. Results Participants experienced significant BMI reduction (average decrease of 7.5 kg [standard deviation, SD=4.2] and 2.9 BMI points [SD=1.4]). Participants also exhibited significant improvements in body esteem, self-esteem, self-efficacy, generic and weight-related quality of life, anti-fat attitudes, and the importance placed on appearance. Changes in self-efficacy, physical functioning and social functioning remained significant even after adjusting for initial zBMI, BMI change, and length of stay. Gender differences were found on changes in self-efficacy, depressive symptoms, and social functioning. Conclusion Participation in weight loss programs in a group setting, such as a camp, may have added benefit beyond BMI reduction. Greater attention to changes in psychosocial variables may be warranted when designing such programs for youth. PMID:19107660

Is a comparative clinical trial for breast cancer tumor markers to monitor disease recurrence warranted? A value of information analysis

PubMed Central

Thariani, Rahber; Henry, Norah Lynn; Ramsey, Scott D; Blough, David K; Barlow, Bill; Gralow, Julie R; Veenstra, David L

2014-01-01

Background Breast cancer tumor markers are used by some clinicians to screen for disease recurrence risk. Since there is limited evidence of benefit, additional research may be warranted. Aim To assess the potential value of a randomized clinical trial of breast tumor marker testing in routine follow-up of high-risk, stage II–III breast cancer survivors. Materials & methods We developed a decision-analytic model of tumor marker testing plus standard surveillance every 3–6 months for 5 years. The expected value of sample information was calculated using probabilistic simulations and was a function of: the probability of selecting the optimal monitoring strategy with current versus future information; the impact of choosing the nonoptimal strategy; and the size of the population affected. Results The value of information for a randomized clinical trial involving 9000 women was US$214 million compared with a cost of US$30–60 million to conduct such a trial. The probability of making an alternate, nonoptimal decision and choosing testing versus no testing was 32% with current versus future information from the trial. The impact of a nonoptimal decision was US$2150 and size of population impacted over 10 years was 308,000. The value of improved information on overall survival was US$105 million, quality of life US$37 million and test performance US$71 million. Conclusion Conducting a randomized clinical trial of breast cancer tumor markers appears to offer a good societal return on investment. Retrospective analyses to assess test performance and evaluation of patient quality of life using tumor markers may also offer valuable areas of research. However, alternative investments may offer even better returns in investments and, as such, the trial concept deserves further study as part of an overall research-portfolio evaluation. PMID:24236631

Impacts of surface water diversions for marijuana cultivation on aquatic habitat in four northwestern California watersheds.

PubMed

Bauer, Scott; Olson, Jennifer; Cockrill, Adam; van Hattem, Michael; Miller, Linda; Tauzer, Margaret; Leppig, Gordon

2015-01-01

Marijuana (Cannabis sativa L.) cultivation has proliferated in northwestern California since at least the mid-1990s. The environmental impacts associated with marijuana cultivation appear substantial, yet have been difficult to quantify, in part because cultivation is clandestine and often occurs on private property. To evaluate the impacts of water diversions at a watershed scale, we interpreted high-resolution aerial imagery to estimate the number of marijuana plants being cultivated in four watersheds in northwestern California, USA. Low-altitude aircraft flights and search warrants executed with law enforcement at cultivation sites in the region helped to validate assumptions used in aerial imagery interpretation. We estimated the water demand of marijuana irrigation and the potential effects water diversions could have on stream flow in the study watersheds. Our results indicate that water demand for marijuana cultivation has the potential to divert substantial portions of streamflow in the study watersheds, with an estimated flow reduction of up to 23% of the annual seven-day low flow in the least impacted of the study watersheds. Estimates from the other study watersheds indicate that water demand for marijuana cultivation exceeds streamflow during the low-flow period. In the most impacted study watersheds, diminished streamflow is likely to have lethal or sub-lethal effects on state- and federally-listed salmon and steelhead trout and to cause further decline of sensitive amphibian species.

A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

PubMed Central

Williams, Jacob M.; McCrae, Christina S.; Rodrigue, James R.; Patton, Pamela R.

2016-01-01

Study Objectives: Sleep and fatigue difficulties appear to be highly prevalent among individuals with end-stage renal disease and individuals who have received a kidney transplant. While there is some evidence of biopsychosocial factors predicting sleep disturbance in these populations, previous studies have relied on single time point retrospective measurements. Methods: The study utilized a 2-week prospective measurement approach, including one night of polysomnographic measurement, nightly sleep diaries, and self-report measures of health, sleep, and mood. Results: The current study demonstrates that a number of psychological and behavioral factors, including negative mood, quality of life, napping, and caffeine consumption, are related to sleep disturbance among pre- and post-kidney transplant patients. This study also found that many of these factors have different relationships with sleep disturbance when comparing pre- and post-kidney transplant patients. Conclusions: These results suggest that such factors may be worthwhile areas for intervention in treating the symptoms of insomnia among pre- and post-transplant recipients. A nuanced approach to understanding sleep problems is likely warranted when conceptualizing insomnia and developing a treatment plan. Citation: Williams JM, McCrae CS, Rodrigue JR, Patton PR. A novel application of a biopsychosocial theory in the understanding of disturbed sleep before and after kidney transplantation. J Clin Sleep Med 2016;12(2):247–256. PMID:26350606

Impacts of Surface Water Diversions for Marijuana Cultivation on Aquatic Habitat in Four Northwestern California Watersheds

PubMed Central

Cockrill, Adam; van Hattem, Michael; Miller, Linda; Tauzer, Margaret; Leppig, Gordon

2015-01-01

Marijuana (Cannabis sativa L.) cultivation has proliferated in northwestern California since at least the mid-1990s. The environmental impacts associated with marijuana cultivation appear substantial, yet have been difficult to quantify, in part because cultivation is clandestine and often occurs on private property. To evaluate the impacts of water diversions at a watershed scale, we interpreted high-resolution aerial imagery to estimate the number of marijuana plants being cultivated in four watersheds in northwestern California, USA. Low-altitude aircraft flights and search warrants executed with law enforcement at cultivation sites in the region helped to validate assumptions used in aerial imagery interpretation. We estimated the water demand of marijuana irrigation and the potential effects water diversions could have on stream flow in the study watersheds. Our results indicate that water demand for marijuana cultivation has the potential to divert substantial portions of streamflow in the study watersheds, with an estimated flow reduction of up to 23% of the annual seven-day low flow in the least impacted of the study watersheds. Estimates from the other study watersheds indicate that water demand for marijuana cultivation exceeds streamflow during the low-flow period. In the most impacted study watersheds, diminished streamflow is likely to have lethal or sub-lethal effects on state-and federally-listed salmon and steelhead trout and to cause further decline of sensitive amphibian species. PMID:25785849

Closure Devices for Iatrogenic Thoraco-Cervical Vascular Injuries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Makris, Gregory C., E-mail: g.makris09@doctors.org.uk; Patel, Rafiuddin; Little, Mark

IntroductionThe unintentional arterial placement of a central venous line can have catastrophic complications. The purpose of this systematic review is to assess and analyse the available evidence regarding the use of the various vascular closure devices (VCDs) for the management of iatrogenic thoraco-cervical arterial injuries (ITCAI).MethodsA systematic review was performed according to PRISMA guidelines.ResultsThirty-two relevant case series and case reports were identified with a total of 69 patients having being studied. In the majority of the studies, plug-based VCDs were used (81%) followed by suture-based devices (19%). The majority of studies reported successful outcomes from the use of VCDs inmore » terms of achieving immediate haemostasis without any acute complications. Long-term follow-up data were only available in nine studies with only one case of carotid pseudoaneurysm being reported after 1-month post-procedure. All other cases had no reported long-term complications. Five studies performed direct or indirect comparisons between VCDs and other treatments (open surgery or stent grafting) suggesting no significant differences in safety or effectiveness.ConclusionAlthough there is limited evidence, VCDs appear to be safe and effective for the management of ITCAIs. Further research is warranted regarding the effectiveness of this approach in comparison to surgery and in order to identify those patients who are more likely to benefit from this minimally invasive approach.« less

A pilot study on the effects of individually tailored education for MMR vaccine-hesitant parents on MMR vaccination intention

PubMed Central

Gowda, Charitha; Schaffer, Sarah E.; Kopec, Kristin; Markel, Arielle; Dempsey, Amanda F.

2013-01-01

Healthcare providers need strategies to better address the concerns of vaccine-hesitant parents. We studied whether individually tailored education was more effective than untailored education at improving vaccination intention among MMR vaccine-hesitant parents. In an intervention pilot study of parents (n = 77) of children < 6 y who screened as hesitant to vaccinate against MMR (first or second dose), parents were randomly assigned to receive either (1) educational web pages that were individually tailored to address their specific vaccine concerns; or (2) web pages similar in appearance to the intervention but containing untailored information. The main outcome, change in vaccination intention before and after the intervention, was assessed using an 11-pt scale (higher values indicated greater intent). We found that a greater proportion of parents in the tailored than untailored arm had positive vaccination intentions after viewing educational information (58% vs. 46%). Furthermore, parents in the tailored group had a greater magnitude of change in vaccination intention (1.08 vs. 0.49 points) than participants in the untailored group. However, neither of these results was statistically significant. From this pilot study we conclude message tailoring may be an effective way to improve vaccine compliance among vaccine hesitant parents. However, larger studies are warranted to further investigate the efficacy of providing tailored education for increasing vaccine acceptance among parents with diverse beliefs. PMID:23291937

Occupational therapy students' attitudes towards inclusion education in Australia, United Kingdom, United States and Taiwan.

PubMed

Mu, Keli; Brown, Ted; Peyton, Claudia G; Rodger, Sylvia; Huang, Yan-Hua; Wu, Chin-Yu; Watson, Callie; Stagnitti, Karen; Hutton, Eve; Casey, Jackie; Hong, Chia Swee

2010-03-01

This international, cross-cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry-level occupational therapy education programmes from Australia, the United Kingdom, the United States and Taiwan participated in the study. Among them, 264 were freshmen (first-year students) and 221 were seniors (final-year students). Data collected from a custom-designed questionnaire were analysed both quantitatively and qualitatively. In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities. Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted.

Methamphetamine exposure and chronic illness in police officers

PubMed Central

Ross, Gerald H; Sternquist, Marie C

2012-01-01

Background: The medical literature reports health hazards for law enforcement personnel from repeated exposure to methamphetamine and related chemical compounds. Most effects appear transitory, but some Utah police officers with employment-related methamphetamine exposures developed chronic symptoms, some leading to disability. This report is of an uncontrolled retrospective medical chart evaluation of symptomatic officers treated with a sauna detoxification protocol designed to reduce the chronic symptoms and improve the quality of life. Methods: Sixty-nine officers consecutively entering the Utah Meth Cops Project were assessed before and after a treatment program involving gradual exercise, comprehensive nutritional support and physical sauna therapy. Evaluations included pre- and post-treatment scores of the Research and Development Corporation (RAND) 36-item Short Form Health Survey (SF-36) in comparison with RAND population norms, pre- and post-treatment symptom score intensities, neurotoxicity scores, Mini-Mental Status Examination, presenting symptom frequencies and a structured evaluation of treatment program safety. Results: Statistically significant health improvements were seen in the SF-36 evaluations, symptom scores and neurotoxicity scores. The detoxification protocol was well tolerated, with a 92.8% completion rate. Conclusions: This investigation strongly suggests that utilizing sauna and nutritional therapy may alleviate chronic symptoms appearing after chemical exposures associated with methamphetamine-related law enforcement activities. This report also has relevance to addressing the apparent ill effects of other complex chemical exposures. In view of the positive clinical outcomes in this group, broader investigation of this sauna-based treatment regimen appears warranted. PMID:22089658

The Anthropocene is functionally and stratigraphically distinct from the Holocene.

PubMed

Waters, Colin N; Zalasiewicz, Jan; Summerhayes, Colin; Barnosky, Anthony D; Poirier, Clément; Gałuszka, Agnieszka; Cearreta, Alejandro; Edgeworth, Matt; Ellis, Erle C; Ellis, Michael; Jeandel, Catherine; Leinfelder, Reinhold; McNeill, J R; Richter, Daniel deB; Steffen, Will; Syvitski, James; Vidas, Davor; Wagreich, Michael; Williams, Mark; Zhisheng, An; Grinevald, Jacques; Odada, Eric; Oreskes, Naomi; Wolfe, Alexander P

2016-01-08

Human activity is leaving a pervasive and persistent signature on Earth. Vigorous debate continues about whether this warrants recognition as a new geologic time unit known as the Anthropocene. We review anthropogenic markers of functional changes in the Earth system through the stratigraphic record. The appearance of manufactured materials in sediments, including aluminum, plastics, and concrete, coincides with global spikes in fallout radionuclides and particulates from fossil fuel combustion. Carbon, nitrogen, and phosphorus cycles have been substantially modified over the past century. Rates of sea-level rise and the extent of human perturbation of the climate system exceed Late Holocene changes. Biotic changes include species invasions worldwide and accelerating rates of extinction. These combined signals render the Anthropocene stratigraphically distinct from the Holocene and earlier epochs. Copyright © 2016, American Association for the Advancement of Science.

Active and Passive Physician-Assisted Dying and the Terminal Disease Requirement.

PubMed

Varelius, Jukka

2016-11-01

The view that voluntary active euthanasia and physician-assisted suicide should be made available for terminal patients only is typically warranted by reference to the risks that the procedures are seen to involve. Though they would appear to involve similar risks, the commonly endorsed end-of-life practices referred to as passive euthanasia are available also for non-terminal patients. In this article, I assess whether there is good reason to believe that the risks in question would be bigger in the case of voluntary active euthanasia and physician-assisted suicide than in that of passive euthanasia. I propose that there is not. On that basis, I suggest that limiting access to voluntary active euthanasia and physician-assisted suicide to terminal patients only is not consistent with accepting the existing practices of passive euthanasia. © 2016 John Wiley & Sons Ltd.

Treatment of Linear Scleroderma (en Coup de Sabre) With Dermal Fat Grafting.

PubMed

Barin, Ensar Zafer; Cinal, Hakan; Cakmak, Mehmet Akif; Tan, Onder

2016-05-01

Linear scleroderma, also known as "en coup de sabre," is a subtype of localized scleroderma that warrants aesthetic correction because it appears on the forehead region in children. To report dermal fat grafting as a novel and effective surgical treatment option in linear scleroderma. Under local anesthesia, a dermal fat graft was successfully placed into a subcutaneous pocket that was prepared underneath the depressed scar. The donor site was closed primarily. No early or late complications developed postoperatively. After 1-year follow-up, the dermal fat graft was viable, the depressed scar was adequately augmented, and a good aesthetic result and patient satisfaction were obtained. We believe that dermal fat grafting is a cost-effective option and provides a long-lasting aesthetic outcome in the management of linear scleroderma. © The Author(s) 2015.

Unilateral proptosis and orbital cellulitis in eight African hedgehogs (Atelerix albiventris).

PubMed

Wheler, C L; Grahn, B H; Pocknell, A M

2001-06-01

Eight African hedgehogs (Atelerix albiventris) were presented with unilateral proptosis. Six animals presented specifically for an ocular problem, whereas two had concurrent neurologic disease. Enucleation and light microscopic examination of tissues was performed in five animals, and euthanasia followed by complete postmortem examination was performed in three animals. Histopathologic findings in all hedgehogs included orbital cellulitis, panophthalmitis, and corneal ulceration, with perforation in seven of eight eyes. The etiology of the orbital cellulitis was not determined, but it appeared to precede proptosis. Orbits in hedgehogs are shallow and the palpebral fissures are large, which may predispose them to proptosis, similar to brachycephalic dogs. This clinical presentation was seen in 15% (8/54) of African hedgehogs presented to the Western College of Veterinary Medicine over a 2-yr period from January 1995 to December 1996 and warrants further investigation.

Bridge deck deterioration study : final report.

DOT National Transportation Integrated Search

1975-03-01

The basic purpose of this study was to investigate three bridges in the northern section of Louisiana in an attempt to determine if there is sufficient deterioration and corrosion of the reinforcing steel to warrant a comprehensive study of bridge de...

Self-rated health: patterns in the journeys of patients with multi-morbidity and frailty.

PubMed

Martin, Carmel Mary

2014-12-01

Self-rated health (SRH) is a single measure predictor of hospital utilization and health outcomes in epidemiological studies. There have been few studies of SRH in patient journeys in clinical settings. Reduced resilience to stressors, reflected by SRH, exposes older people (complex systems) to the risk of hospitalization. It is proposed that SRH reflects rather than predicts deteriorations and hospital use; with low SRH autocorrelation in time series. The aim was to investigate SRH fluctuations in regular outbound telephone calls (average biweekly) to patients by Care Guides. Descriptive case study using quantitative autoregressive techniques and qualitative case analysis on SRH time series. Fourteen participants were randomly selected from the Patient Journey Record System (PaJR) database. The PaJR database recorded 198 consecutively sampled older multi-morbid patients journeys in three primary care settings. Analysis consisted of triangulation of SRH (0 very poor - 6 excellent) patterns from three analyses: SRH graduations associations with service utilization; time series modelling (autocorrelation, and step ahead forecast); and qualitative categorization of deteriorations. Fourteen patients reported mean SRH 2.84 (poor-fair) in 818 calls over 13 ± 6.4 months of follow-up. In 24% calls, SRH was poor-fair and significantly associated with hospital use. SRH autocorrelation was low in 14 time series (-0.11 to 0.26) with little difference (χ(2)  = 6.46, P = 0.91) among them. Fluctuations between better and worse health were very common and poor health was associated with hospital use. It is not clear why some patients continued on a downward trajectory, whereas others who destabilized appeared to completely recover, and even improved over time. SRH reflects an individual's complex health trajectory, but as a single measure does not predict when and how deteriorations will occur in this study. Individual patients appear to behave as complex adaptive systems. The dynamics of SRH and its influences in destabilizations warrant further research. © 2014 John Wiley & Sons, Ltd.

What implementation interventions increase cancer screening rates? a systematic review

PubMed Central

2011-01-01

Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as the evidentiary foundation for an implementation guideline. Poor reporting, lack of precision and consistency in defining operational elements, and insufficient consideration of context and differences among populations are areas for additional research. PMID:21958556

Structure and function of the temporomandibular joint disc: implications for tissue engineering.

PubMed

Detamore, Michael S; Athanasiou, Kyriacos A

2003-04-01

The temporomandibular joint (TMJ) disc is a little understood structure that, unfortunately, exhibits a plethora of pathologic disorders. Tissue engineering approaches may be warranted to address TMJ disc pathophysiology, but first a clear understanding of structure-function relationships needs to be developed, especially as they relate to the regenerative potential of the tissue. In this review, we correlate the biochemical content of the TMJ disc to its mechanical behavior and discuss what this correlation infers for tissue engineering studies of the TMJ disc. The disc of the TMJ exhibits a somewhat biconcave shape, being thicker in the anterior and posterior bands and thinner in the intermediate zone. The disc, which is certainly an anisotropic and nonhomogeneous tissue, consists almost entirely of type I collagen with trace amounts of type II and other types. In general, collagen fibers in the intermediate zone appear to run primarily in an anteroposterior direction and in a ringlike fashion around the periphery. Collagen orientation is reflected in higher tensile stiffness and strength in the center anteroposteriorly than mediolaterally and in the anterior and posterior bands than the intermediate zone mediolaterally. Tensile tests have shown the disc is stiffer and stronger in the direction of the collagen fibers. Elastin fibers in general appear along the collagen fibers and most likely function in restoring and retaining disc form after loading. The 2 primary glycosaminoglycans of the disc by far are chondroitin sulfate and dermatan sulfate, although their distribution is not clear. Compression studies are conflicting, but evidence suggests the disc is compressively stiffest in the center. Only a few tissue engineering studies of the TMJ disc have been performed to date. Tissue engineering studies must take advantage of existing information for experimental design and construct validation, and more research is necessary to characterize the disc to create a clearer picture of our goals in tissue engineering the TMJ disc. Copyright 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:494-506, 2003

Intramuscular diaphragmatic stimulation for patients with traumatic high cervical injuries and ventilator dependent respiratory failure: A systematic review of safety and effectiveness.

PubMed

Garara, Bhavin; Wood, Alasdair; Marcus, Hani J; Tsang, Kevin; Wilson, Mark H; Khan, Mansoor

2016-03-01

Intramuscular diaphragmatic stimulation using an abdominal laparoscopic approach has been proposed as a safer alternative to traditional phrenic nerve stimulation. It has also been suggested that early implementation of diaphragmatic pacing may prevent diaphragm atrophy and lead to earlier ventilator independence. The aim of this study was therefore to systematically review the safety and effectiveness of intramuscular diaphragmatic stimulators in the treatment of patients with traumatic high cervical injuries resulting in long-term ventilator dependence, with particular emphasis on the affect of timing of insertion of such stimulators. The Cochrane database and PubMed were searched between January 2000 and June 2015. Reference lists of selected papers were also reviewed. The inclusion criteria used to select from the pool of eligible studies were: (1) reported on adult patients with traumatic high cervical injury, who were ventilator-dependant, (2) patients underwent intramuscular diaphragmatic stimulation, and (3) commented on safety and/or effectiveness. 12 articles were included in the review. Reported safety issues post insertion of intramuscular electrodes included pneumothorax, infection, and interaction with pre-existing cardiac pacemaker. Only one procedural failure was reported. The percentage of patients reported as independent of ventilatory support post procedure ranged between 40% and 72.2%. The mean delay of insertion ranged from 40 days to 9.7 years; of note the study with the average shortest delay in insertion reported the greatest percentage of fully weaned patients. Although evidence for intramuscular diaphragmatic stimulation in patients with high cervical injuries and ventilator dependent respiratory failure is currently limited, the technique appears to be safe and effective. Earlier implantation of such devices does not appear to be associated with greater surgical risk, and may be more effective. Further high quality studies are warranted to investigate the impact of delay of insertion on ventilator weaning. Copyright © 2016 Elsevier Ltd. All rights reserved.

A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

PubMed

Lee, Tih-Shih; Goh, Siau Juinn Alexa; Quek, Shin Yi; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Teng, Stephanie Sze Wei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Ng, Tze Pin; Lee, Jimmy; Keefe, Richard; Krishnan, K Ranga Rama

2013-01-01

Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI) training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15) and waitlist control arms (n = 16). Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; p<0.001). Specifically, there were significant improvements in immediate memory (p = 0.038), visuospatial/constructional (p = 0.014), attention (p = 0.039), and delayed memory (p<0.001) scores. Our BCI-based system shows promise in improving memory and attention in healthy elderly, and appears to be safe, user-friendly and acceptable to senior users. Given the efficacy signal, a phase III trial is warranted. ClinicalTrials.gov NCT01661894.

How Successful Is Medicare Advantage?

PubMed Central

Newhouse, Joseph P; McGuire, Thomas G

2014-01-01

Context Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. Methods This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Findings Beneficiaries make “mistakes” in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of “zero-premium” plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Conclusions Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan membership are warranted to move more beneficiaries into MA. PMID:24890251

How successful is Medicare Advantage?

PubMed

Newhouse, Joseph P; McGuire, Thomas G

2014-06-01

Medicare Part C, or Medicare Advantage (MA), now almost 30 years old, has generally been viewed as a policy disappointment. Enrollment has vacillated but has never come close to the penetration of managed care plans in the commercial insurance market or in Medicaid, and because of payment policy decisions and selection, the MA program is viewed as having added to cost rather than saving funds for the Medicare program. Recent changes in Medicare policy, including improved risk adjustment, however, may have changed this picture. This article summarizes findings from our group's work evaluating MA's recent performance and investigating payment options for improving its performance even more. We studied the behavior of both beneficiaries and plans, as well as the effects of Medicare policy. Beneficiaries make "mistakes" in their choice of MA plan options that can be explained by behavioral economics. Few beneficiaries make an active choice after they enroll in Medicare. The high prevalence of "zero-premium" plans signals inefficiency in plan design and in the market's functioning. That is, Medicare premium policies interfere with economically efficient choices. The adverse selection problem, in which healthier, lower-cost beneficiaries tend to join MA, appears much diminished. The available measures, while limited, suggest that, on average, MA plans offer care of equal or higher quality and for less cost than traditional Medicare (TM). In counties, greater MA penetration appears to improve TM's performance. Medicare policies regarding lock-in provisions and risk adjustment that were adopted in the mid-2000s have mitigated the adverse selection problem previously plaguing MA. On average, MA plans appear to offer higher value than TM, and positive spillovers from MA into TM imply that reimbursement should not necessarily be neutral. Policy changes in Medicare that reform the way that beneficiaries are charged for MA plan membership are warranted to move more beneficiaries into MA. © 2014 Milbank Memorial Fund.

A Cost-Effectiveness Analysis of Surgery for Middle-Aged Men with Severe Obstructive Sleep Apnea Intolerant of CPAP

PubMed Central

Tan, Kelvin B.; Toh, Song Tar; Guilleminault, Christian; Holty, Jon-Erik C.

2015-01-01

Study Objectives: Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Conventional OSA therapy necessitates indefinite continuous positive airway pressure (CPAP). Although CPAP is an effective treatment modality, up to 50% of OSA patients are intolerant of CPAP. We explore whether surgical modalities developed for those intolerant of CPAP are cost-effective. Methods: We construct a lifetime semi-Markov model of OSA that accounts for observed increased risks of stroke, cardiovascular disease, and motor vehicle collisions for a 50-year-old male with untreated severe OSA. Using this model, we compare the cost-effectiveness of (1) no treatment, (2) CPAP only, and (3) CPAP followed by surgery (either palatopharyngeal reconstructive surgery [PPRS] or multilevel surgery [MLS]) for those intolerant to CPAP. Results: Compared with the CPAP only strategy, CPAP followed by PPRS (CPAP-PPRS) adds 0.265 quality adjusted life years (QALYs) for an increase of $2,767 (discounted 2010 dollars) and is highly cost effective with an incremental cost-effectiveness ratio (ICER) of $10,421/QALY for a 50-year-old male with severe OSA. Compared to a CPAP-PPRS strategy, the CPAP-MLS strategy adds 0.07 QALYs at an increase of $6,213 for an ICER of $84,199/QALY. The CPAP-PPRS strategy appears cost-effective over a wide range of parameter estimates. Conclusions: Palatopharyngeal reconstructive surgery appears cost-effective in middle-aged men with severe OSA intolerant of CPAP. Further research is warranted to better define surgical candidacy as well as short-term and long-term surgical outcomes. Commentary: A commentary on this article appears in this issue on page 509. Citation: Tan KB, Toh ST, Guilleminault C, Holty JE. A cost-effectiveness analysis of surgery for middle-aged men with severe obstructive sleep apnea intolerant of CPAP. J Clin Sleep Med 2015;11(5):525–535. PMID:25700871

Environmental & Psychosocial Contributors to Learning Disparities

EPA Science Inventory

Purpose: Studies suggest early traffic-related pollution exposures (TRPEs) adversely impact cognitive development (COGDEV). Since racial differences do not explain the widening achievement gap, determining TRPE contributions is warranted. Study objectives were to (1) assess the...

The urothelium of a hibernator: the American black bear

PubMed Central

Spector, David A; Deng, Jie; Coleman, Richard; Wade, James B

2015-01-01

The American black bear undergoes a 3–5 month winter hibernation during which time bears do not eat, drink, defecate, or urinate. During hibernation renal function (GFR) is 16–50% of normal but urine is reabsorbed across the urinary bladder (UB) urothelium thus enabling metabolic recycling of all urinary constituents. To elucidate the mechanism(s) whereby urine is reabsorbed, we examined the UBs of five nonhibernating wild bears using light, electron (EM), and confocal immunofluorescent (IF) microscopy–concentrating on two components of the urothelial permeability barrier – the umbrella cell apical membranes and tight junctions (TJ). Bear UB has the same tissue layers (serosa, muscularis, lamina propria, urothelia) and its urothelia has the same cell layers (basal, intermediate, umbrella cells) as other mammalians. By EM, the bear apical membrane demonstrated a typical mammalian scalloped appearance with hinge and plaque regions – the latter containing an asymmetric trilaminar membrane and, on IF, uroplakins Ia, IIIa, and IIIb. The umbrella cell TJs appeared similar to those in other mammals and also contained TJ proteins occludin and claudin - 4, and not claudin –2. Thus, we were unable to demonstrate urothelial apical membrane or TJ differences between active black bears and other mammals. Expression and localization of UT-B, AQP-1 and -3, and Na+, K+-ATPase on bear urothelial membranes was similar to that of other mammals. Similar studies of urothelia of hibernating bears, including evaluation of the apical membrane lipid bilayer and GAGs layer are warranted to elucidate the mechanism(s) whereby hibernating bears reabsorb their daily urine output and thus ensure successful hibernation. PMID:26109187

A critical analysis of the biological impacts of plasticizers on wildlife

PubMed Central

Oehlmann, Jörg; Schulte-Oehlmann, Ulrike; Kloas, Werner; Jagnytsch, Oana; Lutz, Ilka; Kusk, Kresten O.; Wollenberger, Leah; Santos, Eduarda M.; Paull, Gregory C.; Van Look, Katrien J. W.; Tyler, Charles R.

2009-01-01

This review provides a critical analysis of the biological effects of the most widely used plasticizers, including dibutyl phthalate, diethylhexyl phthalate, dimethyl phthalate, butyl benzyl phthalate and bisphenol A (BPA), on wildlife, with a focus on annelids (both aquatic and terrestrial), molluscs, crustaceans, insects, fish and amphibians. Moreover, the paper provides novel data on the biological effects of some of these plasticizers in invertebrates, fish and amphibians. Phthalates and BPA have been shown to affect reproduction in all studied animal groups, to impair development in crustaceans and amphibians and to induce genetic aberrations. Molluscs, crustaceans and amphibians appear to be especially sensitive to these compounds, and biological effects are observed at environmentally relevant exposures in the low ng l−1 to µg l−1 range. In contrast, most effects in fish (except for disturbance in spermatogenesis) occur at higher concentrations. Most plasticizers appear to act by interfering with the functioning of various hormone systems, but some phthalates have wider pathways of disruption. Effect concentrations of plasticizers in laboratory experiments coincide with measured environmental concentrations, and thus there is a very real potential for effects of these chemicals on some wildlife populations. The most striking gaps in our current knowledge on the impacts of plasticizers on wildlife are the lack of data for long-term exposures to environmentally relevant concentrations and their ecotoxicity when part of complex mixtures. Furthermore, the hazard of plasticizers has been investigated in annelids, molluscs and arthropods only, and given the sensitivity of some invertebrates, effects assessments are warranted in other invertebrate phyla. PMID:19528055

The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials.

PubMed

Komishon, A M; Shishtar, E; Ha, V; Sievenpiper, J L; de Souza, R J; Jovanovski, E; Ho, H V T; Duvnjak, L S; Vuksan, V

2016-10-01

Pre-clinical evidence indicates the potential for ginseng to reduce cardiovascular disease risk and acutely aid in blood pressure (BP) control. Clinical evidence evaluating repeated ginseng exposure, however, is controversial, triggering consumer and clinician concern. A systematic review and meta-analysis were conducted to assess whether ginseng has an effect on BP. MEDLINE, EMBASE, Cochrane and CINAHL were searched for relevant randomized controlled trials ⩾4 weeks that compared the effect of ginseng on systolic (SBP), diastolic (DBP) and/or mean arterial (MAP) BPs to control. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled using random-effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed and quantified. Seventeen studies satisfied eligibility criteria (n=1381). No significant effect of ginseng on SBP, DBP and MAP was found. Stratified analysis, although not significant, appears to favour systolic BP improvement in diabetes, metabolic syndrome and obesity (MD=-2.76 mm Hg (95% CI=-6.40, 0.87); P=0.14). A priori subgroup analyses revealed significant association between body mass index and treatment differences (β=-0.95 mm Hg (95% CI=-1.56, -0.34); P=0.007). Ginseng appears to have neutral vascular affects; therefore, should not be discouraged for concern of increased BP. More high-quality, randomized, controlled trials assessing BP as a primary end point, and use of standardized ginseng root or extracts are warranted to limit evidence of heterogeneity in ginseng research and to better understand its cardiovascular health potential.

Measuring Resident Well-Being: Impostorism and Burnout Syndrome in Residency

PubMed Central

Legassie, Jenny; Zibrowski, Elaine M.

2008-01-01

Background Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. Objectives To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Design Anonymous, cross-sectional postal survey. Participants Forty-eight internal medicine residents (postgraduate year [PGY] 1–3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Measurements and Main Results Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI’s personal accomplishment subscale (r = −.30; 95% CI −.54 to −.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Conclusions Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study. PMID:18612750

Concentrations of metals in feathers and blood of nestling Black-Crowned Night-Herons (Nycticorax nycticorax) in Chesapeake and Delaware Bays

USGS Publications Warehouse

Golden, N.H.; Rattner, B.A.; McGowan, P.C.; Parsons, K.C.; Ottinger, M.A.

2003-01-01

Over the past decade, destruction and degradation of wetland habitat has contributed to the decline of wading bird colonies on the Atlantic Coast. In 1998, an initial assessment of the possible contribution of metal pollution to declining heron populations in Chesapeake and Delaware Bays was conducted. Study sites included two heronries in industrialized locations (Pea Patch Island, DE and Baltimore Harbor, MD), and a reference site (Holland Island) remotely located in the southern Chesapeake Bay. Concentrations of 19 metals, metalloids, and trace elements were examined in blood and breast feathers of 14-16 day old nestling black-crowned night-herons. Metal concentrations in blood were low and showed few site differences, though mercury was elevated at Pea Patch Island as compared to other sites. In feathers, metal concentrations appeared to be in the low to moderate range at all sites, though limited data exist for interpreting pollutant concentrations in feathers of nestling wading birds. Where differences were detected, concentrations at Pea Patch Island were consistently greater than those at Baltimore Harbor and Holland Island. Feathers collected at Pea Patch Island had significantly greater concentrations of aluminum, barium, iron, lead, magnesium, and manganese, but were generally found to be within the range of concentrations detected in other nestling birds, where that information was available. Based on these results, metal pollution does not appear to be an immediate threat to BCNH colonies at these two locations, though future monitoring of some elements (Pb, Mn, and Al) may be warranted.

The effects of taurolidine alone and in combination with doxorubicin or carboplatin in canine osteosarcoma in vitro.

PubMed

Marley, Kevin; Helfand, Stuart C; Edris, Wade A; Mata, John E; Gitelman, Alix I; Medlock, Jan; Séguin, Bernard

2013-01-18

Osteosarcoma (OS) affects over 8000 dogs/year in the United States. The disease usually arises in the appendicular skeleton and metastasizes to the lung. Dogs with localized appendicular disease benefit from limb amputation and chemotherapy but most die within 6-12 months despite these treatments. Taurolidine, a derivative of taurine, has anti-tumor and anti-angiogenic effects against a variety of cancers. The following in vitro studies tested taurolidine as a candidate for adjuvant therapy for canine OS. Tests for p53 protein status and caspase activity were used to elucidate mechanisms of taurolidine-induced cell death. Taurolidine was cytotoxic to osteosarcoma cells and increased the toxicity of doxorubicin and carboplatin in vitro. Apoptosis was greatly induced in cells exposed to 125 μM taurolidine and less so in cells exposed to 250 μM taurolidine. Taurolidine cytotoxicity appeared caspase-dependent in one cell line; with apparent mutant p53 protein. This cell line was the most sensitive to single agent taurolidine treatment and had a taurolidine-dependent reduction in accumulated p53 protein suggesting taurolidine's effects may depend on the functional status of p53 in canine OS. Taurolidine's cytotoxic effect appears dependent on cell specific factors which may be explained, in part, by the functional status of p53. Taurolidine initiates apoptosis in canine OS cells and this occurs to a greater extent at lower concentrations. Mechanisms of cell death induced by higher concentrations were not elucidated here. Taurolidine combined with doxorubicin or carboplatin can increase the toxicity of these chemotherapy drugs and warrants further investigation in dogs with osteosarcoma.

Descriptive and predictive validity of somatic attributions in patients with somatoform disorders: a systematic review of quantitative research.

PubMed

Douzenis, Athanassios; Seretis, Dionysis

2013-09-01

Research on hypochondriasis and other somatoform disorders (SFD) has provided evidence that patients with SFD tend to attribute their symptoms to organic dysfunctions or disease. However, recent studies appear to discredit this. There is no systematic evidence on whether patients with SFD predominantly rely on somatic attributions, despite calls to include somatic attributions as a positive criterion of somatic symptom disorder (SSD) in the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This study is a systematic review of quantitative studies which assess the descriptive and predictive validity of somatic attribution in SFD. The literature search was restricted to studies with patients who met the DSM-IV criteria for SFD. Somatic attribution style in SFD has acceptable descriptive but insufficient predictive validity. This confirms that the overlap between somatic and psychological attributions is often substantial. Attribution style can discriminate between SFD patients with and without comorbidity. A somatic attribution style does not qualify as a positive criterion in SSD. However, there is an urgent need for further research on causal illness perceptions in the full spectrum of medically unexplained symptoms in order to confirm this result. Given its high prevalence, research on psychological attribution style is warranted. Re-attribution does not provide a framework sophisticated enough to address the needs of patients in primary care. Copyright © 2013 Elsevier Inc. All rights reserved.

DIETARY FOLATE, VITAMIN B-12, VITAMIN B-6 AND INCIDENT ALZHEIMER’S DISEASE: THE CACHE COUNTY MEMORY, HEALTH, AND AGING STUDY

PubMed Central

NELSON, C.; WENGREEN, H.J.; MUNGER, R.G.; CORCORAN, C.D.

2013-01-01

Objective To examine associations between dietary and supplemental folate, vitamin B-12 and vitamin B-6 and incident Alzheimer’s disease (AD) among elderly men and women. Design, Setting and Participants Data collected were from participants of the Cache County Memory, Health and Aging Study, a longitudinal study of 5092 men and women 65 years and older who were residents of Cache County, Utah in 1995. Measurements Multistage clinical assessment procedures were used to identify incident cases of AD. Dietary data were collected using a 142-item food frequency questionnaire. Cox Proportional Hazards (CPH) modeling was used to determine hazard ratios across quintiles of micronutrient intake. Results 202 participants were diagnosed with incident AD during follow-up (1995–2004). In multivariable CPH models that controlled for the effects of gender, age, education, and other covariates there were no observed differences in risk of AD or dementia by increasing quintiles of total intake of folate, vitamin B-12, or vitamin B-6. Similarly, there were no observed differences in risk of AD by regular use of either folate or B6 supplements. Conclusion Dietary intake of B-vitamins from food and supplemental sources appears unrelated to incidence of dementia and AD. Further studies examining associations between dietary intakes of B-vitamins, biomarkers of B-vitamin status and cognitive endpoints are warranted. PMID:19924351

Scientific skepticism and new discoveries: an analysis of a report of zinc/phytase supplementation and the efficacy of botulinum toxins in treating cosmetic facial rhytides, hemifacial spasm and benign essential blepharospasm.

PubMed

Cohen, Joel L

2014-10-01

A recent paper in the Journal of Drugs in Dermatology by Koshy and colleagues (2012, 11( 4 ):507-512) report on "Effect of Dietary Zinc and Phytase Supplementation on Botulinum Toxin Treatments" and conclude by claiming the discovery of "a potentially meaningful role for zinc and/or phytase supplementation in increasing the degree and duration of botulinum toxin effect in the treatment of cosmetic facial rhytids, benign essential blepharospasm, and hemifacial spasm". The purpose of this paper is to examine these published claims for possible methodological and design errors and potential sources of bias. The authors evaluated the published results in comparison to the published literature on zinc deficiency, the role of phytase, prior reports of an effect of zinc on activity of botulinum toxin, issues of study design and execution and if the reported results of the study supported the study's conclusions. Multiple issues are present in the reported study, which appear to invalidate its conclusions. These areas include lack of direct evidence for the presence of clinical or subclinical zinc deficiency in the study population or for the level of phytate in the study population sufficient to interfere with zinc absorption in these subjects. Additionally, there is ambiguity as to the actual dose of zinc used as well as in the study design itself. Also there is a failure of the study through the "unmasking" of the crossover design. There is potential financial conflict of interest in the study execution that may have biased the reported results. Finally there is inadequate data presented to evaluate the claims made of a "new discovery" as to the three disease entities reported on and the various botulinum toxins used in each of the three treatment arms of the study. Based on this evaluation, it appears that a high level of clinical and scientific skepticism is warranted concerning any claim of a beneficial effect of zinc and phytase supplementation on the efficacy or potency of any botulinum toxins in the reported conditions.

Accept, distract, or reframe? An exploratory experimental comparison of strategies for coping with intrusive body image thoughts in anorexia nervosa and body dysmorphic disorder.

PubMed

Hartmann, Andrea S; Thomas, Jennifer J; Greenberg, Jennifer L; Rosenfield, Elizabeth H; Wilhelm, Sabine

2015-02-28

Negative body image is the hallmark of anorexia nervosa (AN) and body dysmorphic disorder (BDD). One aspect of body image, appearance-related thoughts, have shown to be a major contributor to relapse, thus further investigation of successful treatment strategies targeting these maladaptive thoughts are warranted. The present study tested an acceptance/mindfulness (AC), a cognitive restructuring (CR), and a distraction strategy with regard to their short-term effectiveness of reducing the frequency of thought occurrence and associated outcomes in participants with AN (n=20), BDD (n=21), and healthy controls (HC; n=22). Although all strategies led to a significant reduction of thought frequency, there was no group × strategy interaction effect in their reduction. Positive affect increased in the BDD group through the AC strategy, but decreased in healthy controls. Acceptance of the thought increased in the CR strategy in AN, whereas that strategy seemed to work least for BDD. Healthy controls showed most acceptance when using distraction. Taken together, the study suggests that all strategies might have their benefits and that it might be worthwhile further investigating differential indication of the strategies with regard to diagnosis and individual factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A genetic analysis of Trichuris trichiura and Trichuris suis from Ecuador.

PubMed

Meekums, Hayley; Hawash, Mohamed B F; Sparks, Alexandra M; Oviedo, Yisela; Sandoval, Carlos; Chico, Martha E; Stothard, J Russell; Cooper, Philip J; Nejsum, Peter; Betson, Martha

2015-03-19

Since the nematodes Trichuris trichiura and T. suis are morphologically indistinguishable, genetic analysis is required to assess epidemiological cross-over between people and pigs. This study aimed to clarify the transmission biology of trichuriasis in Ecuador. Adult Trichuris worms were collected during a parasitological survey of 132 people and 46 pigs in Esmeraldas Province, Ecuador. Morphometric analysis of 49 pig worms and 64 human worms revealed significant variation. In discriminant analysis morphometric characteristics correctly classified male worms according to host species. In PCR-RFLP analysis of the ribosomal Internal Transcribed Spacer (ITS-2) and 18S DNA (59 pig worms and 82 human worms), nearly all Trichuris exhibited expected restriction patterns. However, two pig-derived worms showed a "heterozygous-type" ITS-2 pattern, with one also having a "heterozygous-type" 18S pattern. Phylogenetic analysis of the mitochondrial large ribosomal subunit partitioned worms by host species. Notably, some Ecuadorian T. suis clustered with porcine Trichuris from USA and Denmark and some with Chinese T. suis. This is the first study in Latin America to genetically analyse Trichuris parasites. Although T. trichiura does not appear to be zoonotic in Ecuador, there is evidence of genetic exchange between T. trichiura and T. suis warranting more detailed genetic sampling.

Skeletal unloading and dietary copper depletion are detrimental to bone quality of mature rats

NASA Technical Reports Server (NTRS)

Smith, Brenda J.; King, Jarrod B.; Lucas, Edralin A.; Akhter, Mohammed P.; Arjmandi, Bahram H.; Stoecker, Barbara J.

2002-01-01

This study was designed to examine the skeletal response to copper depletion and mechanical unloading in mature animals. In a 2 x 2 experimental design, 5.5-mo-old male Sprague-Dawley rats (n = 36) consumed either the control (AIN-93M) or Cu-depletion ((-)Cu) diet beginning 21 d before suspension and throughout the remainder of the study. Half of the rats in each dietary treatment group were either tail-suspended (TS) or kept ambulatory (AMB) for 28 d. Lower bone mineral densities (BMD) of 5th lumbar vertebra (L5) (P < 0.05) and femur were observed with (-)Cu and TS, but no differences were noted in the BMD of the humerus. Mechanical strength in the femur and vertebra decreased in response to TS, but were unaffected by copper depletion. Urinary deoxypyridinoline, an index of bone resorption, was significantly greater in TS rats, but unaltered by (-)Cu. No changes in serum or bone alkaline phosphatase activity, an indicator of bone formation, were observed. Our findings suggest that TS and (-)Cu decreased BMD in unloaded femur and vertebra but had no effect on normally loaded humerus. Bone loss with TS appeared to be related to accelerated bone resorption. Alterations in bone metabolism and bone mechanical properties in the mature skeleton resulting from (-)Cu warrant further investigation.

A demonstration of mobile phone deployment to support the treatment of acutely ill children under five in Bushenyi district, Uganda.

PubMed

Kabakyenga, Jerome; Barigye, Celestine; Brenner, Jennifer; Maling, Samuel; Buchner, Denise; Nettle-Aquirre, Alberto; Singhal, Nalini; Kyomuhangi, Teddy; Tumusiime, David; Finch, Janet; MacLeod, Stuart

2016-03-01

Benefits of mobile phone deployment for children <5 in low-resource settings remain unproven. The target population of the current demonstration study in Bushenyi District, Uganda, presented with acute fever, pneumonia, or diarrhoea and were treated by community health workers (CHWs) providing integrated community case management (iCCM). An observational study was conducted in five parishes (47 villages) served by CHWs well versed in iCCM with supplemental training in mobile phone use. Impact was assessed by quantitative measures and qualitative evaluation through household surveys, focus group discussions, and key informant interviews. CHWs in targeted sites improved child healthcare through mobile phone use coupled with iCCM. Of acutely ill children, 92.6% were correctly managed. Significant improvements in clinical outcomes compared to those obtained by CHWs with enhanced iCCM training alone were unproven in this limited demonstration. Nonetheless, qualitative evaluation showed gains in treatment planning, supply management, and logistical efficiency. Provider confidence and communications were enhanced as was ease and accuracy of record keeping. Mobile phones appear synergistic with iCCM to bolster basic supportive care for acutely ill children provided by CHWs. The full impact of expanded mobile phone deployment warrants further evaluation prior to scaling up in low-resource settings.

Learning styles in vertically integrated teaching.

PubMed

Brumpton, Kay; Kitchener, Scott; Sweet, Linda

2013-10-01

With vertical integration, registrars and medical students attend the same educational workshops. It is not known whether these learners have similar or different learning styles related to their level of education within the medical training schema. This study aims to collect information about learning styles with a view to changing teaching strategies. If a significant difference is demonstrated this will impact on required approaches to teaching. The VARK learning inventory questionnaire was administered to 36 general practice registrars and 20 medical students. The learning styles were compared as individuals and then related to their level of education within the medical training schema. Students had a greater preference for multimodal learning compared with registrars (62.5 per cent versus 33.3 per cent, respectively). More than half of the registrars preferred uni or bimodal learning modalities, compared with one-third of the medical students. The present workshop format based on visual and aural material will not match the learning needs of most learners. This small study has shown that the majority of medical students and registrars could have their learning preferences better met by the addition of written material to the workshop series. Surprisingly, a significantly larger number of medical students than registrars appeared to be broadly multimodal in their learning style, and this warrants further research. © 2013 John Wiley & Sons Ltd.

Are loss of control while eating and overeating valid constructs? A critical review of the literature

PubMed Central

Goldschmidt, Andrea B.

2017-01-01

Background Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet, its component constructs—overeating and loss of control (LOC) while eating—are poorly understood and difficult to measure. Objective To critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. Data sources English-language articles addressing the face, convergent, discriminant, and predictive validity of LOC and overeating were included. Results LOC and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial, and eating behavior-related factors. Overeating may be best conceptualized as a marker of excess weight status. Limitations Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. Discussion Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented. PMID:28165655

Relationship between scapular muscle and core endurance in healthy subjects.

PubMed

Hazar Kanik, Zeynep; Pala, Omer Osman; Gunaydin, Gurkan; Sozlu, Ugur; Alkan, Zeynep Beyza; Basar, Selda; Citaker, Seyit

2017-01-01

Scapular muscle endurance and core endurance reportedly influence shoulder injury risk. The exact relationship between scapular muscle endurance and core endurance, and how they impact one another in the healthy subjects remain unclear. To investigate the relationship between scapular muscle endurance and core endurance in healthy subjects. Fifty healthy volunteers (23 males, 27 females; mean age 20.42 ± 1.04 years) were participated in this study. Endurance of the serratus anterior and trapezius muscles was assessed using the scapular muscle endurance test. Sorensen test (endurance of trunk extensor muscles), trunk flexor endurance test, and side bridge test (endurance of lateral core muscles) were conducted to assess the core endurance. Pearson's product moment correlations examined relationships between scapular muscle endurance and each of the core endurance tests scores. Scapular muscle endurance test scores showed a positive correlation with the side bridge test scores (r = 0.414; p = 0.003). No significant correlation was found between scapular muscle endurance test scores and the other core endurance tests scores (p > 0.05). There appears to be a link between the scapular muscle endurance and lateral core muscles in healthy subjects; however, more research is needed to provide a definitive answer on the nature of this relationship. Further studies involving patients with shoulder pathology are warranted.

Treatment of cyclical mastalgia with a solution containing a Vitex agnus castus extract: results of a placebo-controlled double-blind study.

PubMed

Halaska, M; Beles, P; Gorkow, C; Sieder, C

1999-08-01

In a placebo-controlled, randomized, double-blind study the efficacy of a Vitex agnus castus extract-containing solution (VACS) was investigated in patients suffering from cyclical mastalgia. Patients had mastalgia on at least 5 days in the pre-treatment cycle. During this cycle and during treatment (3 cycles; 2 x 30 drops/day), the intensity of mastalgia was recorded once per cycle using a visual analogue scale (VAS). After one/two treatment cycles, the mean decrease in pain intensity (mm, VAS) was 21.4 mm /33.7 mm in women taking VACS (n=48) and 10.6 mm/20.3 mm with placebo (n=49). The differences of the VAS-values for VACS were significantly greater than those with placebo (p=0.018; p=0.006). After three cycles, the mean VAS-score reduction for women taking VACS was 34.3 mm, a reduction of 'borderline significance' (p=0.064) on statistical testing compared with placebo (25.7 mm). There was no difference in the frequency of adverse events between both groups (VACS: n=5; placebo : n=4). VACS appears effective and was well tolerated and further evaluation of this agent in the treatment of cyclical mastalgia is warranted.

Use of pooled samples to assess human exposure to parabens, benzophenone-3 and triclosan in Queensland, Australia

PubMed Central

Heffernan, A.L.; Baduel, C.; Toms, L.M.L.; Calafat, A.M.; Ye, X.; Hobson, P.; Broomhall, S.; Mueller, J.F.

2017-01-01

Parabens, benzophenone-3 and triclosan are common ingredients used as preservatives, ultraviolet radiation filters and antimicrobial agents, respectively. Human exposure occurs through consumption of processed food and use of cosmetics and consumer products. The aim of this study was to provide a preliminary characterisation of exposure to selected personal care product chemicals in the general Australian population. De-identified urine specimens stratified by age and sex were obtained from a community-based pathology laboratory and pooled (n = 24 pools of 100). Concentrations of free and total (sum of free plus conjugated) species of methyl, ethyl, propyl and butyl paraben, benzophenone-3 and triclosan were quantified using isotope dilution tandem mass spectrometry; with geometric means 232, 33.5, 60.6, 4.32, 61.5 and 87.7 ng/mL, respectively. Age was inversely associated with paraben concentration, and females had concentrations approximately two times higher than males. Total paraben and benzophenone-3 concentrations are significantly higher than reported worldwide, and the average triclosan concentration was more than one order of magnitude higher than in many other populations. This study provides the first data on exposure of the general Australian population to a range of common personal care product chemical ingredients, which appears to be prevalent and warrants further investigation. PMID:26368661

Two-Dimensional Differential In-Gel Electrophoresis Proteomic Approaches Reveal Urine Candidate Biomarkers in Pediatric Obstructive Sleep Apnea

PubMed Central

Gozal, David; Jortani, Saeed; Snow, Ayelet B.; Kheirandish-Gozal, Leila; Bhattacharjee, Rakesh; Kim, Jinkwan; Capdevila, Oscar Sans

2009-01-01

Rationale: Sleep studies are laborious, expensive, inaccessible, and inconvenient for diagnosing obstructive sleep apnea (OSA) in children. Objectives: To examine whether the urinary proteome uncovers specific clusters that are differentially expressed in the urine of children with OSA. Methods: Two-dimensional differential in-gel electrophoresis (2D-DIGE) and mass spectrometry proteomics followed by validation with western blot of ELISA. Measurements and Main Results: Morning urine proteins from 60 children with polysomnographically confirmed OSA and from matched children with primary snoring (n = 30) and control subjects (n = 30) were assessed. A total of 16 proteins that are differentially expressed in OSA were identified, and 7 were confirmed by either immunoblots or ELISA. Among the latter, receiver–operator curve analyses of urinary concentrations of uromodulin, urocortin-3, orosomucoid-1, and kallikrein assigned favorable predictive properties to these proteins. Furthermore, combinatorial approaches indicated that the presence of values beyond the calculated cutoff concentrations for three or more of the proteins yielded a sensitivity of 95% and a specificity of 100%. Conclusions: Proteomic approaches reveal that pediatric OSA is associated with specific and consistent alterations in urinary concentrations of specific protein clusters. Future studies aiming to validate this approach as a screening method of habitually snoring children appears warranted. PMID:19797158

Translocator protein (TSPO) ligands for the diagnosis or treatment of neurodegenerative diseases: a patent review (2010-2015; part 1).

PubMed

Kim, TaeHun; Pae, Ae Nim

2016-11-01

The translocator protein (TSPO) is an emerging target in diverse neurodegenerative diseases. Up-regulated TSPO in the central nervous system (CNS) appears to be involved in neuroinflammatory processes; therefore, the development of potent TSPO ligands is a promising method for alleviating or imaging patients with neurodegenerative diseases. Areas covered: This review will provide an overview of recently developed TSPO ligands patented from 2010 to 2015. Part 1 will present a summary focusing on TSPO ligands other than indole-based or cholesterol-like compounds, which will be discussed in part 2. Part 1 covers diverse benzodiazepine-derived analogues such as isoquinoline carboxamides and aryloxyanilides. Moreover, bicyclic ring structures such as imidazopyridine, pyrazolopyrimidine, and phenylpurine will be highlighted as promising scaffolds for TSPO ligands. A brief analysis of currently reported TSPO structures will also be covered in part 1. Expert opinion: Although the underlying pharmacological mechanism of TSPO remains to be elucidated, several TSPO ligands have shown therapeutic efficacy in experimental animal models of neurodegenerative diseases. In addition, radioactive TSPO ligands have been extensively studied for the diagnosis of neurodegenerative processes. Thus, further studies on both the basic and applied mechanisms of TSPO are warranted in the pursuit of successful pharmacological applications of TSPO ligands.

Potential misdiagnosis of von Willebrand disease and haemophilia caused by ineffective mixing of thawed plasma.

PubMed

Favaloro, E J; Oliver, S; Mohammed, S; Ahuja, M; Grzechnik, E; Azimulla, S; McDonald, J; Lima-Oliveira, G; Lippi, G

2017-09-01

von Willebrand disease (VWD) reflects a loss or dysfunction in von Willebrand factor (VWF), while haemophilia represents a loss or dysfunction of clotting factors such as factor VIII (FVIII) or FIX. Their diagnosis requires laboratory testing, with this potentially compromised by preanalytical events, including poor sample quality. This study assessed the effect of inadequate mixing as a potential cause of VWD and haemophilia misdiagnosis. After completion of requested testing, 48 consecutive patient samples comprising separate aliquots from single collections were individually pooled, appropriately mixed, then frozen in separate aliquots, either at -20°C or -80°C for 2-7 days. Each sample set was then thawed and the separate aliquots subjected to separate mixing protocols (several inversions, blood roller, vortex) vs a non-mix sample, and all aliquots then tested for various VWF and factor assays. Non-mixing led to substantial reduction in VWF and factors in about 25% of samples, that in some cases could lead to misdiagnosis of VWD or haemophilia. Interestingly, there were also some differences observed with respect to different mixing protocols. Our study identified ineffective or variable mixing of thawed plasma samples as potential causes of misdiagnosis of VWD or haemophilia. Further education regarding the importance of appropriate mixing appears warranted. © 2017 John Wiley & Sons Ltd.

Crisis occurrence and resolution in patients with severe and persistent mental illness: the contribution of suicidality.

PubMed

Links, Paul S; Eynan, Rahel; Ball, Jeffrey S; Barr, Aiala; Rourke, Sean

2005-01-01

Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.

Opportunities for mourning when grief is disenfranchised: descendants of Nazi perpetrators in dialogue with Holocaust survivors.

PubMed

Livingston, Kathy

2010-01-01

This article explores the concepts of unmourned and disenfranchised grief as a way to understand the experiences of adult children of Nazi perpetrators, who grew up with cultural norms of grieving alone or in silence. The scholarly literature on descendants of Nazis reflects a group unlikely to warrant empathy or support from others because of the stigma surrounding their family's possible involvement in the Holocaust atrocities. This article uses, as a case study approach, the testimony given by Monika Hertwig, the adult daughter of a high ranking Nazi, who appears in the documentary film, Inheritance. From the perspective of disenfranchised grief, defined as grief that is not socially recognized or supported, the article links Monika's testimony with existing research from in-depth interviews with other descendants of Nazis to suggest that, as a group, they lacked permission to grieve their deceased parents, acknowledgment of their grief, and opportunities to mourn. Based on the theory that the effects of grief can be transgenerational, the disenfranchisement experienced by the "children of the Third Reich" does not have to pass to subsequent generations if opportunities for mourning are made possible and some resolution of grief occurs. Studies have shown that ongoing dialogue groups between Holocaust survivors and descendants of Nazis provide opportunities for mourning to both groups.

Educational attainment and hippocampal atrophy in the Alzheimer's disease neuroimaging initiative cohort.

PubMed

Shpanskaya, Katie S; Choudhury, Kingshuk Roy; Hostage, Christopher; Murphy, Kelly R; Petrella, Jeffrey R; Doraiswamy, P Murali

2014-12-01

Subjects with higher cognitive reserve (CR) may be at a lower risk for Alzheimer's disease (AD), but the neural mechanisms underlying this are not known. Hippocampal volume loss is an early event in AD that triggers cognitive decline. Regression analyses of the effects of education on MRI-measured baseline HV in 675 subjects (201 normal, 329 with mild cognitive impairment (MCI), and 146 subjects with mild AD), adjusting for age, gender, APOE ɛ4 status and intracranial volume (ICV). Subjects were derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI), a large US national biomarker study. The association between higher education and larger HV was significant in AD (P=0.014) but not in cognitively normal or MCI subjects. In AD, HV was about 8% larger in a person with 20 years of education relative to someone with 6 years of education. There was also a trend for the interaction between education and APOE ɛ4 to be significant in AD (P=0.056). A potential protective association between higher education and lower hippocampal atrophy in patients with AD appears consistent with prior epidemiologic data linking higher education levels with lower rates of incident dementia. Longitudinal studies are warranted to confirm these findings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Role of Fat and Bone Biomarkers in the Relationship Between Ethnicity and Bone Mineral Density in Older Men.

PubMed

Chan, Grace M F; Riandini, Tessa; Ng, Sheryl Hui Xian; Goh, Su Yen; Tan, Chuen Seng; Tai, E Shyong; Duque, Gustavo; Ng, Alvin Choon-Meng; Venkataraman, Kavita

2018-01-01

Osteoporosis is an important health issue for older adults, and has been relatively understudied in older men. This study aimed to examine ethnic differences in bone mineral density (BMD), and elucidate the role of bone turnover markers (BTMs), fat and fat biomarkers on these ethnic differences. BMD at the lumbar spine and femoral neck, marrow fat at femoral neck, visceral adipose tissue (VAT) and subcutaneous adipose tissue, bone and fat biomarkers were evaluated in 120 healthy men aged ≥ 60 years. Indians had higher BMD values compared to Chinese at the lumbar spine (β = 20.336, SE = 4.749, p < 0.001) and the femoral neck (e β  = 1.105, SE = 0.032, p < 0.001), after adjusting for BTMs, fat composition and lifestyle choices. Marrow fat, VAT and adiponectin were independent predictors of BMD. However, these factors did not explain the lower BMD observed in older Chinese men. Our findings suggest that older Chinese men are at significant risk of osteoporotic fractures due to lower BMD. Fat appears to be a key factor associated with lower BMD, and warrants further longitudinal studies to elucidate the complex interactions between adipose tissue and bone strength.

Imaging and tracking HIV viruses in human cervical mucus

NASA Astrophysics Data System (ADS)

Boukari, Fatima; Makrogiannis, Sokratis; Nossal, Ralph; Boukari, Hacène

2016-09-01

We describe a systematic approach to image, track, and quantify the movements of HIV viruses embedded in human cervical mucus. The underlying motivation for this study is that, in HIV-infected adults, women account for more than half of all new cases and most of these women acquire the infection through heterosexual contact. The endocervix is believed to be a susceptible site for HIV entry. Cervical mucus, which coats the endocervix, should play a protective role against the viruses. Thus, we developed a methodology to apply time-resolved confocal microscopy to examine the motion of HIV viruses that were added to samples of untreated cervical mucus. From the images, we identified the viruses, tracked them over time, and calculated changes of the statistical mean-squared displacement (MSD) of each virus. Approximately half of tracked viruses appear constrained while the others show mobility with MSDs that are proportional to τα+ν2τ2, over time range τ, depicting a combination of anomalous diffusion (0<α<0.4) and flow-like behavior. The MSD data also reveal plateaus attributable to possible stalling of the viruses. Although a more extensive study is warranted, these results support the assumption of mucus being a barrier against the motion of these viruses.

Developing an Integration Infrastructure for Distributed Engine Control Technologies

NASA Technical Reports Server (NTRS)

Culley, Dennis; Zinnecker, Alicia; Aretskin-Hariton, Eliot; Kratz, Jonathan

2014-01-01

Turbine engine control technology is poised to make the first revolutionary leap forward since the advent of full authority digital engine control in the mid-1980s. This change aims squarely at overcoming the physical constraints that have historically limited control system hardware on aero-engines to a federated architecture. Distributed control architecture allows complex analog interfaces existing between system elements and the control unit to be replaced by standardized digital interfaces. Embedded processing, enabled by high temperature electronics, provides for digitization of signals at the source and network communications resulting in a modular system at the hardware level. While this scheme simplifies the physical integration of the system, its complexity appears in other ways. In fact, integration now becomes a shared responsibility among suppliers and system integrators. While these are the most obvious changes, there are additional concerns about performance, reliability, and failure modes due to distributed architecture that warrant detailed study. This paper describes the development of a new facility intended to address the many challenges of the underlying technologies of distributed control. The facility is capable of performing both simulation and hardware studies ranging from component to system level complexity. Its modular and hierarchical structure allows the user to focus their interaction on specific areas of interest.

Health effects of perceived racial and religious bullying among urban adolescents in China: a cross-sectional national study.

PubMed

Pan, Stephen W; Spittal, Patricia M

2013-07-01

Research concerning ethnocultural bullying and adolescent health in China remains extremely limited. This study among Chinese urban adolescents examines associations between ethnocultural bullying and eight health-related outcomes: suicidal ideation, suicide planning, depressive symptomology, anxiety symptomatology, fighting, injury intentionally inflicted by another, smoking and moderate/heavy alcohol consumption. Data were obtained from the World Health Organisation's 2003 Chinese Global School-based Health Survey, a cross-sectional national survey of urban adolescents in four Chinese cities. The analytic sample size was n = 8182, which represented a sampling frame of 769,835 adolescents. Statistical analysis was conducted using generalised linear mixed effects models and sampling weights. Prevalence of ethnocultural bullying was significantly higher in Urumqi, Xinjiang province (2.08%) compared with Beijing municipality (0.72%) or Wuhan, Hubei province (0.67%). Compared to participants who were not bullied, religious bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and depressive symptomology. Racial bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and among females but not males, depressive symptomology. Health effects of ethnocultural bullying appear to be distinct from that of bullying in general. Additional research on ethnocultural adolescent health issues in China is warranted.

A persistent circhoral ultradian rhythm is identified in human core temperature.

PubMed

Lindsley, G; Dowse, H B; Burgoon, P W; Kolka, M A; Stephenson, L A

1999-01-01

There have been inconclusive reports of intermittent rhythmic fluctuations in human core temperature, with the fluctuations having a period of about an hour. However, there has been no definitive demonstration of the phenomenon. This is likely due to the intermittency and seeming instability of the events. They have been assumed to be secondary rather than autonomous phenomena, putatively arising from the oscillation between rapid eye movement (REM) and non-REM (NREM) sleep. In this study, we report identification of a clear, persistent circhoral ultradian rhythm in core temperature with a period for this study sample of 64 +/- 8 minutes. It appeared simultaneously with an intact circadian core temperature rhythm, persisted despite complex perturbations in core temperature brought about by the sequelae of 40 h of sleep deprivation, and could not be attributed to sleep stage alternation or other endogenous or exogenous factors. Analysis of power spectra using the maximum entropy spectral analysis (MESA) method, which can uncover hidden rhythmicities, demonstrated that the apparent intermittency of the rhythm is due to periodic interference of this rhythm by other rhythmic events. The persistence of this oscillation suggests that, in this system as in the endocrine system, circhoral regulation is an integral component of thermoregulatory control. Identifying the source and functional role of this novel rhythm warrants further work.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Basher, A.M.H.

Poor control of steam generator water level of a nuclear power plant may lead to frequent nuclear reactor shutdowns. These shutdowns are more common at low power where the plant exhibits strong non-minimum phase characteristics and flow measurements at low power are unreliable in many instances. There is need to investigate this problem and systematically design a controller for water level regulation. This work is concerned with the study and the design of a suitable controller for a U-Tube Steam Generator (UTSG) of a Pressurized Water Reactor (PWR) which has time varying dynamics. The controller should be suitable for themore » water level control of UTSG without manual operation from start-up to full load transient condition. Some preliminary simulation results are presented that demonstrate the effectiveness of the proposed controller. The development of the complete control algorithm includes components such as robust output tracking, and adaptively estimating both the system parameters and state variables simultaneously. At the present time all these components are not completed due to time constraints. A robust tracking component of the controller for water level control is developed and its effectiveness on the parameter variations is demonstrated in this study. The results appear encouraging and they are only preliminary. Additional work is warranted to resolve other issues such as robust adaptive estimation.« less

Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment.

PubMed

Tsui, Patricia; Deptula, Andrew; Yuan, Derek Y

2017-06-01

This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

Pitting and Stress Corrosion Cracking Susceptibility of Nanostructured Al-Mg Alloys in Natural and Artificial Environments

NASA Astrophysics Data System (ADS)

Sharma, Mala M.; Ziemian, Constance W.

2008-12-01

The stress corrosion cracking (SCC) behavior of two developmental nanocrystalline 5083 alloys with varied composition and processing conditions was studied. The results were compared to a commercial aluminum AA 5083 (H111) alloy. The pitting densities, size and depths, and residual tensile strengths were measured after alternate immersion in artificial seawater and atmospheric exposure under different loading conditions. Optical and scanning electron microscopy (SEM) with EDX was used to analyze the fracture surfaces of failed specimen after removal at selected intervals and tensile testing. One of the nanostructured Al-Mg alloys exhibited significantly superior pitting resistance when compared to conventional microstructured AA 5083. Under conditions where pitting corrosion showed up as local tunnels toward phase inclusions, transgranular cracking was observed, whereas under conditions when pitting corrosion evolved along grain boundaries, intergranular cracking inside the pit was observed. Pit initiation resistance of the nano alloys appears to be better than that of the conventional alloys. However, long-term pit propagation is a concern and warrants further study. The objective of this investigation was to obtain information regarding the role that ultra-fine microstructures play in their degradation in marine environments and to provide insight into the corrosion mechanisms and damage processes of these alloys.

On the impact of improved dosimetric accuracy on head and neck high dose rate brachytherapy.

PubMed

Peppa, Vasiliki; Pappas, Eleftherios; Major, Tibor; Takácsi-Nagy, Zoltán; Pantelis, Evaggelos; Papagiannis, Panagiotis

2016-07-01

To study the effect of finite patient dimensions and tissue heterogeneities in head and neck high dose rate brachytherapy. The current practice of TG-43 dosimetry was compared to patient specific dosimetry obtained using Monte Carlo simulation for a sample of 22 patient plans. The dose distributions were compared in terms of percentage dose differences as well as differences in dose volume histogram and radiobiological indices for the target and organs at risk (mandible, parotids, skin, and spinal cord). Noticeable percentage differences exist between TG-43 and patient specific dosimetry, mainly at low dose points. Expressed as fractions of the planning aim dose, percentage differences are within 2% with a general TG-43 overestimation except for the spine. These differences are consistent resulting in statistically significant differences of dose volume histogram and radiobiology indices. Absolute differences of these indices are however small to warrant clinical importance in terms of tumor control or complication probabilities. The introduction of dosimetry methods characterized by improved accuracy is a valuable advancement. It does not appear however to influence dose prescription or call for amendment of clinical recommendations for the mobile tongue, base of tongue, and floor of mouth patient cohort of this study. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Sex-Specificity of Oxidative Stress in Newborns Leading to a Personalized Antioxidant Nutritive Strategy.

PubMed

Lavoie, Jean-Claude; Tremblay, André

2018-03-27

Oxidative stress is a critical process that triggers several diseases observed in premature infants. Growing recognition of the detriment of oxidative stress in newborns warrants the use of an antioxidant strategy that is likely to be nutritional in order to restore redox homeostasis. It appears essential to have a personalized approach that will take into account the age of gestation at birth and the sex of the infant. However, the link between sex and oxidative stress remains unclear. The aim of this study was to find a common denominator explaining the discrepancy between studies related to sex-specific effects of oxidative stress. Results highlight a specificity of sex in the levels of oxidative stress markers linked to the metabolism of glutathione, as measured in the intracellular compartments. Levels of all sex-dependent oxidative stress markers are greater and markers associated to a better antioxidant defense are lower in boys compared to girls during the neonatal period. This sex-specific discrepancy is likely to be related to estrogen metabolism, which is more active in baby-girls and promotes the activation of glutathione metabolism. our observations suggest that nutritive antioxidant strategies need to target glutathione metabolism and, therefore, should be personalized considering, among others, the sex specificity.

Impact of Upfront Cellular Enrichment by Laser Capture Microdissection on Protein and Phosphoprotein Drug Target Signaling Activation Measurements in Human Lung Cancer: Implications for Personalized Medicine

PubMed Central

Elisa, Baldelli; B., Haura Eric; Lucio, Crinò; Douglas, Cress W.; Vienna, Ludovini; B., Schabath Matthew; A., Liotta Lance; F., Petricoin Emanuel; Mariaelena, Pierobon

2015-01-01

Purpose The aim of this study was to evaluate whether upfront cellular enrichment via laser capture microdissection is necessary for accurately quantifying predictive biomarkers in non-small cell lung cancer tumors. Experimental design Fifteen snap frozen surgical biopsies were analyzed. Whole tissue lysate and matched highly enriched tumor epithelium via laser capture microdissection (LCM) were obtained for each patient. The expression and activation/phosphorylation levels of 26 proteins were measured by reverse phase protein microarray. Differences in signaling architecture of dissected and undissected matched pairs were visualized using unsupervised clustering analysis, bar graphs, and scatter plots. Results Overall patient matched LCM and undissected material displayed very distinct and differing signaling architectures with 93% of the matched pairs clustering separately. These differences were seen regardless of the amount of starting tumor epithelial content present in the specimen. Conclusions and clinical relevance These results indicate that LCM driven upfront cellular enrichment is necessary to accurately determine the expression/activation levels of predictive protein signaling markers although results should be evaluated in larger clinical settings. Upfront cellular enrichment of the target cell appears to be an important part of the workflow needed for the accurate quantification of predictive protein signaling biomarkers. Larger independent studies are warranted. PMID:25676683

Safety of intrathecal autologous adipose-derived mesenchymal stromal cells in patients with ALS

PubMed Central

Madigan, Nicolas N.; Morris, Jonathan; Jentoft, Mark; Sorenson, Eric J.; Butler, Greg; Gastineau, Dennis; Dietz, Allan; Windebank, Anthony J.

2016-01-01

Objective: To determine the safety of intrathecal autologous adipose-derived mesenchymal stromal cell treatment for amyotrophic lateral sclerosis (ALS). Methods: Participants with ALS were enrolled and treated in this phase I dose-escalation safety trial, ranging from 1 × 107 (single dose) to 1 × 108 cells (2 monthly doses). After intrathecal treatments, participants underwent standardized follow-up, which included clinical examinations, revised ALS Functional Rating Scale (ALSFRS-R) questionnaire, blood and CSF sampling, and MRI of the neuroaxis. Results: Twenty-seven patients with ALS were enrolled and treated in this study. The safety profile was positive, with the most common side effects reported being temporary low back and radicular leg pain at the highest dose level. These clinical findings were associated with elevated CSF protein and nucleated cells with MRI of thickened lumbosacral nerve roots. Autopsies from 4 treated patients did not show evidence of tumor formation. Longitudinal ALSFRS-R questionnaires confirmed continued progression of disease in all treated patients. Conclusions: Intrathecal treatment of autologous adipose-derived mesenchymal stromal cells appears safe at the tested doses in ALS. These results warrant further exploration of efficacy in phase II trials. Classification of evidence: This phase I study provides Class IV evidence that in patient with ALS, intrathecal autologous adipose-derived mesenchymal stromal cell therapy is safe. PMID:27784774

Risk of treatment-related esophageal cancer among breast cancer survivors.

PubMed

Morton, L M; Gilbert, E S; Hall, P; Andersson, M; Joensuu, H; Vaalavirta, L; Dores, G M; Stovall, M; Holowaty, E J; Lynch, C F; Curtis, R E; Smith, S A; Kleinerman, R A; Kaijser, M; Storm, H H; Pukkala, E; Weathers, R E; Linet, M S; Rajaraman, P; Fraumeni, J F; Brown, L M; van Leeuwen, F E; Fossa, S D; Johannesen, T B; Langmark, F; Lamart, S; Travis, L B; Aleman, B M P

2012-12-01

Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use. Nested case-control study of esophageal cancer among 289 748 ≥5-year survivors of female breast cancer from five population-based cancer registries (252 cases, 488 individually matched controls), with individualized radiation dosimetry and information abstracted from medical records. The largest contributors to esophageal radiation exposure were supraclavicular and internal mammary chain treatments. Esophageal cancer risk increased with increasing radiation dose to the esophageal tumor location (P(trend )< 0.001), with doses of ≥35 Gy associated with an odds ratio (OR) of 8.3 [95% confidence interval (CI) 2.7-28]. Patients with hormonal therapy ≤5 years preceding esophageal cancer diagnosis had lower risk (OR = 0.4, 95% CI 0.2-0.8). Based on few cases, alkylating agent chemotherapy did not appear to affect risk. Our data were consistent with a multiplicative effect of radiation and other esophageal cancer risk factors (e.g. smoking). Esophageal cancer is a radiation dose-related complication of radiotherapy for breast cancer, but absolute risk is low. At higher esophageal doses, the risk warrants consideration in radiotherapy risk assessment and long-term follow-up.

Bacterial meningitis in alcoholic patients: A population-based prospective study.

PubMed

van Veen, Kiril E B; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

2017-04-01

To study clinical features and outcome of community-acquired bacterial meningitis in alcoholic patients. Patients with a history of alcoholism were selected from our nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. Of 1359 included episodes, 88 episodes (6%) occurred in 88 alcoholic patients. Seizures as presenting symptom were present in 18% alcoholic patients, and 23% presented with co-existing pneumonia. Causative organisms were Streptococcus pneumoniae in 76%, Listeria monocytogenes in 8%, and Neisseria meningitidis in 6% of patients. A high rate of systemic complications occurred with respiratory failure in 40% and endocarditis in 9% of patients. Outcome was unfavorable in 58% of alcoholic patients, and 25% died. Alcoholism was associated with unfavorable outcome in a multivariate analysis (OR 1.96; 95% CI 1.12-3.46; P = 0.019), but not with death (OR 0.76; 95% CI 0.35-1.68; P = 0.762). Alcoholic bacterial meningitis patients often have an unfavorable outcome, which appears to result from a high rate of systemic complications, mainly respiratory failure. Seizures are common in alcoholic patients and warrant caution of development of an alcohol withdrawal syndrome. Copyright © 2017. Published by Elsevier Ltd.

Respiratory symptoms and ventilatory performance in workers exposed to grain and grain based food dusts.

PubMed

Deacon, S P; Paddle, G M

1998-05-01

A health surveillance study of male grain food manufacturing workers used a respiratory health questionnaire and spirometry to assess the prevalence of work-related respiratory symptoms and impaired ventilatory performance. The prevalence of cough, breathlessness, wheeze and chest tightness was between 8-13% but was 20% for rhinitis. Rhinitis was the most common symptom with 37% of those reporting rhinitis describing this as work-related. A case-control analysis of workers reporting rhinitis did not identify any specific occupational activities associated with increased risk of rhinitis. Smoking habit and all respiratory symptoms apart from rhinitis had a significant effect upon ventilatory performance. Occupational exposure to raw grains, flour, ingredients and finished food was categorized as high, medium or low in either continuous or intermediate patterns. Multiple regression analysis confirmed the effects of height, age and smoking upon ventilatory performance. However, occupational exposure to grain, flour, food ingredients and cooked food dusts had no effect upon ventilatory performance. It is concluded that smoking habit is the major determinant of respiratory symptoms and impaired ventilatory function. The excess complaints of rhinitis warrant further study but it would appear that the current occupational exposure limits for grain, flour, food ingredients and cooked food dusts are adequate to protect workers against impairment of ventilatory performance.

The young adult Strengths and Difficulties Questionnaire (SDQ) in routine clinical practice.

PubMed

Brann, Peter; Lethbridge, Melissa J; Mildred, Helen

2018-06-01

Expansion of the youth mental health sector has exposed a need for an outcome measure for young adults accessing services. The Strengths and Difficulties Questionnaire (SDQ) is a widely used consumer and carer outcome measure for children and adolescents. The aim of this study was to evaluate the psychometric properties of a young adult SDQ. The young adult SDQ was introduced for routine clinical practice at Eastern Health Child and Youth Mental Health Service (EH-CYMHS), complementing the well-established adolescent and child versions. Data for adolescents (aged 12-17) and young adults (aged 18-25) where both self-report and parent SDQs had been completed at entry point to the service were extracted from a two-year period. Overall, paired cases involved 532 adolescents and 125 young adults. Across both self-report and parent SDQs, a similar pattern of results was found between adolescents and young adults on mean scores, inter-scale correlations, internal consistency, and inter-rater agreement. The findings of the current study support the use of the young adult SDQ in public mental health as an instrument whose psychometric properties, to date, appear consistent with those of the adolescent version. Further investigation is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Current status of atypical antipsychotics for the treatment of fibromyalgia.

PubMed

Rico-Villademoros, F; Calandre, E P; Slim, M

2014-06-01

The treatment of fibromyalgia requires pharmacological and nonpharmacological therapies. The pharmacological treatment of fibromyalgia is limited to a few drugs that have been demonstrated to be moderately effective in some but not all dimensions of the disease. Therefore, the search for new drugs to treat this condition is warranted. Atypical antipsychotics offered an attractive alternative because they had been shown to be active against several key symptoms of fibromyalgia. The results of open-label studies, however, appear to indicate that atypical antipsychotics are poorly tolerated in patients with fibromyalgia, and only quetiapine XR has been studied in randomized controlled trials. Quetiapine XR has demonstrated effectiveness in treating comorbid major depression, anxiety and sleep disturbance. However, in two randomized controlled trials, quetiapine XR was not differentiated from placebo and failed to demonstrate noninferiority to amitriptyline in terms of improving overall symptomatology. The effect of quetiapine XR on pain and its usefulness as part of a combination pharmacological regimen should be further evaluated. Overall, the use of quetiapine (initiated at a low dose and slowly titrated) in fibromyalgia should be limited to patients with comorbid major depression or patients who are currently receiving other treatments and have unresolved and disabling depressive and/or anxiety symptoms. Copyright 2014 Prous Science, S.A.U. or its licensors. All rights reserved.

A pilot study to evaluate the effects of floatation spa treatment on patients with osteoarthritis.

PubMed

Hill, S; Eckett, M J; Paterson, C; Harkness, E F

1999-12-01

To conduct a preliminary investigation of the effects on floatation spa therapy on quality of life in patients with osteoarthritis to see if controlled trials are warranted. Uncontrolled clinical trial. Private floatation spa therapy centre. Fourteen patients with chronic osteoarthritis of the weight-bearing joints, of whom four dropped out. Six weekly sessions of floatation spa therapy. SF36, AIMS2 and MYMOP quality-of-life questionnaires. All patients improved. Differences between baseline and discharge scores showed statistically significant improvement for MYMOP, but not AIMS2 or SF-36. Controlled trials of floatation spa therapy for patients with osteoarthritis are warranted.

Clinical research evidence of cupping therapy in China: a systematic literature review.

PubMed

Cao, Huijuan; Han, Mei; Li, Xun; Dong, Shangjuan; Shang, Yongmei; Wang, Qian; Xu, Shu; Liu, Jianping

2010-11-16

Though cupping therapy has been used in China for thousands of years, there has been no systematic summary of clinical research on it.This review is to evaluate the therapeutic effect of cupping therapy using evidence-based approach based on all available clinical studies. We included all clinical studies on cupping therapy for all kinds of diseases. We searched six electronic databases, all searches ended in December 2008. We extracted data on the type of cupping and type of diseases treated. 550 clinical studies were identified published between 1959 and 2008, including 73 randomized controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports. Number of RCTs obviously increased during past decades, but the quality of the RCTs was generally poor according to the risk of bias of the Cochrane standard for important outcome within each trials. The diseases in which cupping was commonly employed included pain conditions, herpes zoster, cough or asthma, etc. Wet cupping was used in majority studies, followed by retained cupping, moving cupping, medicinal cupping, etc. 38 studies used combination of two types of cupping therapies. No serious adverse effects were reported in the studies. According to the above results, quality and quantity of RCTs on cupping therapy appears to be improved during the past 50 years in China, and majority of studies show potential benefit on pain conditions, herpes zoster and other diseases. However, further rigorous designed trials in relevant conditions are warranted to support their use in practice.

Dissonance-based prevention of eating disorder risk factors in middle school girls: results from two pilot trials.

PubMed

Rohde, Paul; Auslander, Beth A; Shaw, Heather; Raineri, Kate M; Gau, Jeff M; Stice, Eric

2014-07-01

Although several eating disorder prevention programs reduce eating disorder risk factors and symptoms for female high school and college students, few efficacious prevention programs exist for female middle school students, despite the fact that body image and eating disturbances often emerge then. Two pilot trials evaluated a new dissonance-based eating disorder prevention program for middle school girls with body image concerns. Female middle school students with body dissatisfaction from two sites [Study 1: N = 81, M age = 12.1, standard deviation (SD) = 0.9; Study 2: N = 52, M age = 12.5, SD = 0.8] were randomized to a dissonance intervention (MS Body Project) or educational brochure control; Study 2 included a 3-month follow-up. Intervention participants showed significant post-test reductions in only one of the six variables with both Studies 1 and 2 (i.e., pressure to be thin and negative affect, respectively), though post-test effect sizes suggested medium reductions in eating disorder risk factors and symptoms (Study 1: M d = .40; Study 2: M d = .65); reductions at 3-month follow-up in Study 2 were not evident (M d = .19). Results suggest that this new middle school version of the Body Project is producing medium magnitude reductions in eating disorder risk factors at post-test but that effects are showing limited persistence. Continued refinement and evaluation of this intervention appears warranted to develop more effective prevention programs for this age group. © 2014 Wiley Periodicals, Inc.

New Hampshire critical access hospitals: CEOs' report on ethical challenges.

PubMed

Nelson, William; Rosenberg, Marie-Claire; Weiss, Julie; Goodrich, Martha

2009-01-01

Research into the importance of organizational healthcare ethics has increasingly appeared in healthcare publications. However, to date, few published studies have examined ethical issues from the perspective of healthcare executives, and no empirical study has addressed organizational ethics with an explicit focus on rural hospitals. For our study, we sought to identify the frequency of ethical conflicts occurring within 12 general categories (domains) of administrative activities. Also, we wanted to determine what ethics resources are currently available and whether additional resources would be helpful. We conducted a structured telephone interview of all 13 chief executive officers (CEOs) of critical access hospitals in New Hampshire. All the CEOs in the study indicated that they encountered ethical conflicts. On average, the three most frequently noted domains were organizational-professional staff relations, reimbursement, and clinical care. All CEOs indicated they would like to have additional ethics resources to address these conflicts. This study verified that CEOs encounter a broad spectrum of ethical conflicts and need additional ethics resources to address them. Because this study used a small sample of CEOs and represented only one New England state, further ethics-related research in rural healthcare facilities is warranted. Follow-up study would allow for (1) a higher level of generalization of the findings, (2) clarity regarding specific ethical dilemmas that rural healthcare executives encounter, and (3) an assessment of ethics resources and training that healthcare executives need to address the ethical conflicts.

Stair negotiation as a rehabilitation intervention for enhancing recovery following total hip and knee replacement surgery.

PubMed

Gavin, James P; Immins, Tikki; Wainwright, Thomas

2017-05-01

Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation intervention it appears to be rarely used. The review purpose was to investigate the effectiveness of stair climbing as a rehabilitation intervention for THR and TKR patients. MEDLINE, PsycINFO, Science Citation Index, CINAHL, SPORTDiscus and the Cochrane Database of Systematic Reviews were searched. The systematic review targeted studies using stair negotiation as a rehabilitation intervention. Randomised and non-randomised controlled trials, pilot studies, and case studies were included; systematic reviews and meta-analyses were excluded. Of 650 articles identified, ten studies were eligible for review. A predefined data table to extract information from selected studies was used. Of the ten identified reports, two prehabilitation and eight rehabilitation studies included stair negotiation exercises as part of multi-modal physical interventions. Outcome measures were classified as: functional self-reported, perceptual, psychological and those relating to quality of life. Studies were methodologically heterogeneous and typically lacked adequate control groups. It was not possible to determine the impact of stair negotiation exercise on the positive outcomes of interventions. Stair negotiation warrants further investigation as a rehabilitation activity. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

40 CFR 146.65 - Construction requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Director may require more than 120% when the geology or other circumstances warrant it. (3) At least one...% when the geology or other circumstances warrant it. (4) Circulation of cement may be accomplished by...

40 CFR 146.65 - Construction requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Director may require more than 120% when the geology or other circumstances warrant it. (3) At least one...% when the geology or other circumstances warrant it. (4) Circulation of cement may be accomplished by...

40 CFR 146.65 - Construction requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Director may require more than 120% when the geology or other circumstances warrant it. (3) At least one...% when the geology or other circumstances warrant it. (4) Circulation of cement may be accomplished by...

40 CFR 146.65 - Construction requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Director may require more than 120% when the geology or other circumstances warrant it. (3) At least one...% when the geology or other circumstances warrant it. (4) Circulation of cement may be accomplished by...

40 CFR 146.65 - Construction requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Director may require more than 120% when the geology or other circumstances warrant it. (3) At least one...% when the geology or other circumstances warrant it. (4) Circulation of cement may be accomplished by...

Midwives' attitudes, beliefs and concerns about childhood vaccination: A review of the global literature.

PubMed

Attwell, K; Wiley, K E; Waddington, C; Leask, J; Snelling, T

2018-02-23

Vaccine hesitancy in industrialised countries is an area of concern. Health professionals play a significant role in parental vaccination decisions, however, to date the role of midwives has not been widely explored. This review sought to describe the attitudes and communication practices of midwives in developed countries towards childhood vaccines. Medline, Cinahl, PsychInfo, Embase and the grey literature were searched. Inclusion criteria were qualitative and quantitative studies reporting midwives' beliefs, attitudes and communication practices toward childhood vaccination. The search returned 366 articles, of which 359 were excluded by abstract. Two additional articles were identified from the grey literature and references, resulting in nine studies from five countries included in the review. Across the studies, the majority of midwives supported vaccination, although a spectrum of beliefs and concerns emerged. A minority expressed reservations about the scientific justification for vaccination, which focussed on what is not yet known rather than mistrust of current evidence. Most midwives felt that vaccines were safe; a minority were unsure, or believed they were unsafe. The majority of midwives agreed that childhood vaccines are necessary. Among those who expressed doubt, a commonly held opinion was that vaccine preventable diseases such as measles are relatively benign and didn't warrant vaccination against them. Finally, the midwifery model of care was shown to focus on providing individualised care, with parental choice being placed at a premium. The midwifery model care appears to differ in approach from others, possibly due to a difference in the underpinning philosophies. Research is needed to understand how midwives see vaccination, and why there appears to be a spectrum of views on the subject. This information will inform the development of resources tailored to the midwifery model of care, supporting midwives in advocating for childhood vaccination. Copyright © 2018. Published by Elsevier Ltd.

Early intervention with an estrogen receptor β-selective phytoestrogenic formulation prolongs survival, improves spatial recognition memory, and slows progression of amyloid pathology in a female mouse model of Alzheimer's disease.

PubMed

Zhao, Liqin; Mao, Zisu; Chen, Shuhua; Schneider, Lon S; Brinton, Roberta D

2013-01-01

Our recent developments have yielded a novel phytoestrogenic formulation, referred to as the phyto-β-SERM formulation, which exhibits an 83-fold binding selectivity for the estrogen receptor subtype β (ERβ) over ERα. Earlier studies indicate that the phyto-β-SERM formulation is neuroprotective and promotes estrogenic mechanisms in the brain while devoid of feminizing activity in the periphery. Further investigation in a mouse model of human menopause indicates that chronic exposure to the phyto-β-SERM formulation at a clinically relevant dosage prevents/alleviates menopause-related climacteric symptoms. This study assessed the efficacy, in an early intervention paradigm, of the phyto-β-SERM formulation in the regulation of early stages of physical and neurological changes associated with Alzheimer's disease (AD) in a female triple transgenic mouse model of AD. Results demonstrated that, when initiated prior to the appearance of AD pathology, a 9-month dietary supplementation with the phyto-β-SERM formulation promoted physical health, prolonged survival, improved spatial recognition memory, and attenuated amyloid-β deposition and plaque formation in the brains of treated AD mice. In comparison, dietary supplementation of a commercial soy extract preparation showed no effect on cognitive measures, although it appeared to have a positive impact on amyloid pathology. In overall agreement with the behavioral and histological outcomes, results from a gene expression profiling analysis offered insights on the underlying molecular mechanisms associated with the two dietary treatments. In particular, the data suggests that there may be a crosstalk between ERβ and glycogen synthase kinase 3 signaling pathways that could play a role in conferring ERβ-mediated neuroprotection against AD. Taken together, these results support the therapeutic potential of the phyto-β-SERM formulation for prevention and/or early intervention of AD, and warrants further investigations in human studies.

An Examination of the Ethnicity-Specific Prevalence of and Factors Associated with Substance Use and Misuse: Cross-Sectional Analysis of Croatian and Bosniak Adolescents in Bosnia and Herzegovina

PubMed Central

Bjelica, Dusko; Idrizovic, Kemal; Popovic, Stevo; Sisic, Nedim; Sekulic, Damir; Ostojic, Ljerka; Spasic, Miodrag; Zenic, Natasa

2016-01-01

Substance use and misuse (SUM) in adolescence is a significant public health problem and the extent to which adolescents exhibit SUM behaviors differs across ethnicity. This study aimed to explore the ethnicity-specific and gender-specific associations among sports factors, familial factors, and personal satisfaction with physical appearance (i.e., covariates) and SUM in a sample of adolescents from Federation of Bosnia and Herzegovina. In this cross-sectional study the participants were 1742 adolescents (17–18 years of age) from Bosnia and Herzegovina who were in their last year of high school education (high school seniors). The sample comprised 772 Croatian (558 females) and 970 Bosniak (485 females) adolescents. Variables were collected using a previously developed and validated questionnaire that included questions on SUM (alcohol drinking, cigarette smoking, and consumption of other drugs), sport factors, parental education, socioeconomic status, and satisfaction with physical appearance and body weight. The consumption of cigarettes remains high (37% of adolescents smoke cigarettes), with a higher prevalence among Croatians. Harmful drinking is also alarming (evidenced in 28.4% of adolescents). The consumption of illicit drugs remains low with 5.7% of adolescents who consume drugs, with a higher prevalence among Bosniaks. A higher likelihood of engaging in SUM is found among children who quit sports (for smoking and drinking), boys who perceive themselves to be good looking (for smoking), and girls who are not satisfied with their body weight (for smoking). Higher maternal education is systematically found to be associated with greater SUM in Bosniak girls. Information on the associations presented herein could be discretely disseminated as a part of regular school administrative functions. The results warrant future prospective studies that more precisely identify the causality among certain variables. PMID:27690078

Florid papillomatosis of the nipple. A study of 51 patients, including nine with mammary carcinoma.

PubMed

Rosen, P P; Caicco, J A

1986-02-01

The present study was undertaken to review the pathology of florid papillomatosis (FP) of the nipple and to examine the relationship of FP to breast carcinoma. Clinical features of 49 women studied did not differ appreciably from those noted on prior reports, except that in one instance the lesion was probably congenital. Histologically, three distinct growth patterns were found: sclerosing papillomatosis (17 cases), papillomatosis (12 cases), and adenosis (3 cases). In 17 other cases, mixtures of these proliferative patterns were seen. FP with the sclerosing papillomatosis pattern more frequently had areas of focal necrosis in hyperplastic ducts and scattered mitoses, features that might be interpreted as evidence of carcinoma. No prognostic significance can be attributed to these patterns, since all types were cured by excision with follow-up that averaged 8.3 years. Seven of the 49 women had carcinoma in the same breast as FP: Two women had invasive carcinoma that appeared to arise from FP, and four women had concurrent invasive carcinomas that were separate from the FP; the seventh woman developed diffuse intraductal carcinoma 10 years after FP was excised from the same breast. Three of the seven women were also treated for contralateral breast carcinoma. Also reviewed were lesions from two men who had carcinoma arising in FP. One had intraductal carcinoma with Paget's disease and the other had invasive carcinoma. Appreciation of the diverse histological patterns of FP may be helpful in avoiding an erroneous diagnosis of carcinoma. Features indicative of carcinoma arising in FP are Paget's disease and areas of invasion. FP of the nipple is rarely the substrate for mammary carcinoma and is adequately treated by local excision. Coexistence with carcinoma elsewhere in the same or opposite breast occurs often enough to warrant thorough examination of the breasts when FP of the nipple is diagnosed. The risk of subsequent carcinoma following excision of FP appears to be low, but clinical follow-up is prudent.

Photovoltaic failure and degradation modes

DOE PAGES

Jordan, Dirk C.; Silverman, Timothy J.; Wohlgemuth, John H.; ...

2017-01-30

The extensive photovoltaic field reliability literature was analyzed and reviewed. Future work is prioritized based upon information assembled from recent installations, and inconsistencies in degradation mode identification are discussed to help guide future publication on this subject. Reported failure rates of photovoltaic modules fall mostly in the range of other consumer products; however, the long expected useful life of modules may not allow for direct comparison. In general, degradation percentages are reported to decrease appreciably in newer installations that are deployed after the year 2000. However, these trends may be convoluted with varying manufacturing and installation quality world-wide. Modules inmore » hot and humid climates show considerably higher degradation modes than those in desert and moderate climates, which warrants further investigation. Delamination and diode/j-box issues are also more frequent in hot and humid climates than in other climates. The highest concerns of systems installed in the last 10 years appear to be hot spots followed by internal circuitry discoloration. Encapsulant discoloration was the most common degradation mode, particularly in older systems. In newer systems, encapsulant discoloration appears in hotter climates, but to a lesser degree. Lastly, thin-film degradation modes are dominated by glass breakage and absorber corrosion, although the breadth of information for thin-film modules is much smaller than for x-Si.« less

Memory and executive functioning in obsessive-compulsive disorder: a selective review.

PubMed

Olley, Amanda; Malhi, Gin; Sachdev, Perminder

2007-12-01

The neurocognitive deficits that underlie the unique features of obsessive-compulsive disorder (OCD) are not yet completely understood. This paper reviews the main neuropsychological findings in memory and executive functioning in this disorder, and examines a number of challenges facing this area of research. A selective review of the neuropsychological literature on OCD was conducted using MEDLINE and drawing on literature known to the authors. The neuropsychological profile of OCD appears to be one of primary executive dysfunction. Although memory functioning may be affected, these deficits appear secondary to an executive failure of organizational strategies during encoding. On tasks of executive functioning patients with OCD demonstrate increased response latencies, perseveration of responses, and difficulties utilizing feedback to adapt to change. A statistical meta-analysis was not performed and only the cognitive domains of memory and executive functioning were examined. Given the prominence of chronic doubt and indecision in clinical settings, it is surprising that decision making as a cognitive construct as related to OCD has not received greater attention in the neuropsychological literature. On the basis of emerging literature we suggest that it is a potential area of dysfunction and one that warrants further investigation as it may assist in enhancing our understanding of the pathophysiology of OCD.

Characterizing Early Psychosocial Functioning of Parents of Children with Moderate to Severe Genital Ambiguity due to Disorders of Sex Development.

PubMed

Suorsa, Kristina I; Mullins, Alexandria J; Tackett, Alayna P; Reyes, Kristy J Scott; Austin, Paul; Baskin, Laurence; Bernabé, Kerlly; Cheng, Earl; Fried, Allyson; Frimberger, Dominic; Galan, Denise; Gonzalez, Lynette; Greenfield, Saul; Kropp, Bradley; Meyer, Sabrina; Meyer, Theresa; Nokoff, Natalie; Palmer, Blake; Poppas, Dix; Paradis, Alethea; Yerkes, Elizabeth; Wisniewski, Amy B; Mullins, Larry L

2015-12-01

We examined the psychosocial characteristics of parents of children with disorders of sex development at early presentation to a disorders of sex development clinic. Parental anxiety, depression, quality of life, illness uncertainty and posttraumatic stress symptoms were assessed. Additionally we evaluated the relationship of assigned child gender to parental outcomes. A total of 51 parents of children with ambiguous or atypical genitalia were recruited from 7 centers specializing in treatment of disorders of sex development. At initial assessment no child had undergone genitoplasty. Parents completed the Cosmetic Appearance Rating Scale, Beck Anxiety Inventory, Beck Depression Inventory, SF-36, Parent Perception of Uncertainty Scale and Impact of Event Scale-Revised. A large percentage of parents (54.5%) were dissatisfied with the genital appearance of their child, and a small but significant percentage reported symptoms of anxiety, depression, diminished quality of life, uncertainty and posttraumatic stress. Few gender differences emerged. Although many parents function well, a subset experience significant psychological distress around the time of diagnosis of a disorder of sex development in their child. Early screening to assess the need for psychosocial interventions is warranted. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Photovoltaic failure and degradation modes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jordan, Dirk C.; Silverman, Timothy J.; Wohlgemuth, John H.

The extensive photovoltaic field reliability literature was analyzed and reviewed. Future work is prioritized based upon information assembled from recent installations, and inconsistencies in degradation mode identification are discussed to help guide future publication on this subject. Reported failure rates of photovoltaic modules fall mostly in the range of other consumer products; however, the long expected useful life of modules may not allow for direct comparison. In general, degradation percentages are reported to decrease appreciably in newer installations that are deployed after the year 2000. However, these trends may be convoluted with varying manufacturing and installation quality world-wide. Modules inmore » hot and humid climates show considerably higher degradation modes than those in desert and moderate climates, which warrants further investigation. Delamination and diode/j-box issues are also more frequent in hot and humid climates than in other climates. The highest concerns of systems installed in the last 10 years appear to be hot spots followed by internal circuitry discoloration. Encapsulant discoloration was the most common degradation mode, particularly in older systems. In newer systems, encapsulant discoloration appears in hotter climates, but to a lesser degree. Lastly, thin-film degradation modes are dominated by glass breakage and absorber corrosion, although the breadth of information for thin-film modules is much smaller than for x-Si.« less

Assessment of physical demands and fluid balance in elite female handball players during a 6-day competitive tournament.

PubMed

Cunniffe, Brian; Fallan, Carissa; Yau, Adora; Evans, Gethin H; Cardinale, Marco

2015-02-01

Little data exists on drinking behavior, sweat loss, and exercise intensity across a competitive handball tournament in elite female athletes. Heart rate (HR), fluid balance and sweat electrolyte content were assessed on 17 international players across a 6-day tournament involving 5 games and 2 training sessions played indoors (23 ± 2 °C, 30 ± 2% relative humidity). Active play (effective) mean HR was 155 ± 14 bpm (80 ± 7.5% HRmax) with the majority of time (64%) spent exercising at intensities >80% HRmax. Mean (SD) sweat rates during games were 1.02 ± 0.07 L · h⁻¹ and on 56% of occasions fluid intake matched or exceeded sweat loss. A significant relationship was observed between estimated sweat loss and fluid intake during exercise (r² = .121, p = .001). Mean sweat sodium concentration was 38 ± 10 mmol · L⁻¹, with significant associations observed between player sweat rates and time spent exercising at intensities >90% HRmax (r² = .181, p = .001). Fluid and electrolyte loss appear to be work rate dependent in elite female handball players, whom appear well capable of replacing fluids lost within a tournament environment. Due to large between-athlete variations, a targeted approach may be warranted for certain players only.

How Nanotechnology and Biomedical Engineering Are Supporting the Identification of Predictive Biomarkers in Neuro-Oncology.

PubMed

Ganau, Mario; Paris, Marco; Syrmos, Nikolaos; Ganau, Laura; Ligarotti, Gianfranco K I; Moghaddamjou, Ali; Prisco, Lara; Ambu, Rossano; Chibbaro, Salvatore

2018-02-26

The field of neuro-oncology is rapidly progressing and internalizing many of the recent discoveries coming from research conducted in basic science laboratories worldwide. This systematic review aims to summarize the impact of nanotechnology and biomedical engineering in defining clinically meaningful predictive biomarkers with a potential application in the management of patients with brain tumors. Data were collected through a review of the existing English literature performed on Scopus, MEDLINE, MEDLINE in Process, EMBASE, and/or Cochrane Central Register of Controlled Trials: all available basic science and clinical papers relevant to address the above-stated research question were included and analyzed in this study. Based on the results of this systematic review we can conclude that: (1) the advances in nanotechnology and bioengineering are supporting tremendous efforts in optimizing the methods for genomic, epigenomic and proteomic profiling; (2) a successful translational approach is attempting to identify a growing number of biomarkers, some of which appear to be promising candidates in many areas of neuro-oncology; (3) the designing of Randomized Controlled Trials will be warranted to better define the prognostic value of those biomarkers and biosignatures.

Species richness and community composition of mat-forming ectomycorrhizal fungi in old- and second-growth Douglas-fir forests of the HJ Andrews Experimental Forest, Oregon, USA.

PubMed

Dunham, Susie M; Larsson, Karl-Henrik; Spatafora, Joseph W

2007-11-01

We investigated the species identity of mat-forming ectomycorrhizal (EM) fungi associated with old- and second-growth Douglas-fir stands. Using molecular analyses of rhizomorphs and EM root tips, we characterized 28 unique internal transcribed spacer sequences and considered them proxies for mat-forming EM species. In both stand age classes, one Athelioid species in the genus Piloderma dominated our sample of the mat-forming fungal community. In second-growth stands, the second most frequently encountered mat-forming EM species belonged to the genus Hysterangium. In old-growth stands, several Ramaria species were associated with a frequently encountered mat morphology but no species dominated the community. After using rarefaction analysis to standardize sampling effort, the total species richness did not differ statistically between old- and second-growth habitats. Both an abundance of infrequently encountered species and incomplete sampling of the mat-forming EM community may have limited our ability to detect potential differences in species richness. Several frequently encountered Piloderma species appear to have broad (holarctic) distributions and diverse host associations and their potential importance in forest ecosystems warrants further study.

Structural health monitoring (vibration) as a tool for identifying structural alterations of the lumbar spine: a twin control study.

PubMed

Kawchuk, Gregory N; Hartvigsen, Jan; Edgecombe, Tiffany; Prasad, Narasimha; van Dieen, Jaap H

2016-03-11

Structural health monitoring (SHM) is an engineering technique used to identify mechanical abnormalities not readily apparent through other means. Recently, SHM has been adapted for use in biological systems, but its invasive nature limits its clinical application. As such, the purpose of this project was to determine if a non-invasive form of SHM could identify structural alterations in the spines of living human subjects. Lumbar spines of 10 twin pairs were visualized by magnetic resonance imaging then assessed by a blinded radiologist to determine whether twin pairs were structurally concordant or discordant. Vibration was then applied to each subject's spine and the resulting response recorded from sensors overlying lumbar spinous processes. The peak frequency, area under the curve and the root mean square were computed from the frequency response function of each sensor. Statistical analysis demonstrated that in twins whose structural appearance was discordant, peak frequency was significantly different between twin pairs while in concordant twins, no outcomes were significantly different. From these results, we conclude that structural changes within the spine can alter its vibration response. As such, further investigation of SHM to identify spinal abnormalities in larger human populations is warranted.

Zhen gan xi feng decoction, a traditional chinese herbal formula, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

PubMed

Xiong, Xingjiang; Yang, Xiaochen; Feng, Bo; Liu, Wei; Duan, Lian; Gao, Ao; Li, Haixia; Ma, Jizheng; Du, Xinliang; Li, Nan; Wang, Pengqian; Su, Kelei; Chu, Fuyong; Zhang, Guohao; Li, Xiaoke; Wang, Jie

2013-01-01

Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH). Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP). Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain. Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.

The Body Mass Index of Adolescents Attending Seventh-Day Adventist Schools in Australia: 2001-2012.

PubMed

Craig, Bevan A; Morton, Darren P; Kent, Lillian M; Butler, Terry L; Rankin, Paul M; Price, Kevin R

2017-08-01

We examined the body mass index (BMI) of students attending Seventh-day Adventist (Adventist) schools in Australia in 2001 and 2012. A total of 3069 students attending Adventist schools in Australia responded to a health and lifestyle survey in 2001 (N = 1335) and 2012 (N = 1734). The survey captured self-reported height and weight, demographics (age, sex, year level, religion), and select health behaviors. Compared with national norms, lower rates of overweight and obesity were observed in the study cohort, but higher rates of underweight. There was no change in the mean BMI of the students attending Adventist schools in Australia from 2001 to 2012. Regression analyses indicated that a lower BMI was associated with age, sex, more regularly eating breakfast, consuming less soft drink, and having a regular exercise program. The students reported a high consumption of fruits, vegetables, and whole grains compared with Australian national norms, and 29% claimed to be vegetarian. Students attending Adventist schools appear to have a lower prevalence of overweight and obesity than the secular population, but a higher prevalence of underweight. The mechanisms through which Adventist schools may influence student's BMI warrants further investigation. © 2017, American School Health Association.

Neuroendocrine Associations Underlying the Persistent Therapeutic Effects of Classic Serotonergic Psychedelics

PubMed Central

Schindler, Emmanuelle A. D.; Wallace, Ryan M.; Sloshower, Jordan A.; D’Souza, Deepak C.

2018-01-01

Recent reports on the effects of psychedelic-assisted therapies for mood disorders and addiction, as well as the effects of psychedelics in the treatment of cluster headache, have demonstrated promising therapeutic results. In addition, the beneficial effects appear to persist well after limited exposure to the drugs, making them particularly appealing as treatments for chronic neuropsychiatric and headache disorders. Understanding the basis of the long-lasting effects, however, will be critical for the continued use and development of this drug class. Several mechanisms, including biological and psychological ones, have been suggested to explain the long-lasting effects of psychedelics. Actions on the neuroendocrine system are some such mechanisms that warrant further investigation in the study of persisting psychedelic effects. In this report, we review certain structural and functional neuroendocrinological pathologies associated with neuropsychiatric disorders and cluster headache. We then review the effects that psychedelic drugs have on those systems and provide preliminary support for potential long-term effects. The circadian biology of cluster headache is of particular relevance in this area. We also discuss methodologic considerations for future investigations of neuroendocrine system involvement in the therapeutic benefits of psychedelic drugs. PMID:29545753

The influence of age on perceptions of anticipated financial inadequacy by palliative radiation outpatients.

PubMed

Francoeur, Richard B

2007-12-01

A consistent body of knowledge suggests that with advancing age, adults tend to report lower financial strain from their current economic condition. But are more negative perceptions shifted onto their expectations about their future economic condition? This study of seriously ill outpatients investigates whether advancing age is related to more negative expectations of future health-related financial strain, in which illness progression would necessitate greater health care consumption. Ordinal probit multivariate regression was conducted on survey findings from 268 outpatients initiating palliative radiation for recurrent cancer. Half were retirees age>/=65. Age comparisons are reported when there was no recent work transition. As age advances (from 40 to 84), outpatients incurring low objective financial stress were more likely to reveal that their health insurance and finances would be less adequate to meet future health needs. Previously, these outpatients were reported to minimize perceptions of current financial strain as age advances. Therefore, older outpatients may cope with current circumstances by displacing perceptions of financial inadequacy onto plausible future situations of cancer progression demanding greater healthcare consumption. Financial strain may be hidden in older outpatients initiating palliative radiation. These outpatients appear at risk of foregoing appropriate healthcare. Targeted screening and advocacy are warranted.

Density of river otters (Lontra canadensis) in relation to energy development in the Green River Basin, Wyoming

USGS Publications Warehouse

Godwin, B.L.; Albeke, S.E.; Bergman, H.L.; Walters, Annika W.; Ben-David, M.

2015-01-01

Exploration and extraction of oil and natural gas have increased in recent years and are expected to expand in the future. Reduction in water quality from energy extraction may negatively affect water supply for agriculture and urban use within catchments as well as down river. We used non-invasive genetic techniques and capture–recapture modeling to estimate the abundance and density of North American river otters (Lontra canadensis), a sentinel species of aquatic ecosystems, in Southwestern Wyoming. While densities in two of three river reaches were similar to those reported in other freshwater systems in the western US (1.45–2.39 km per otter), otters appeared to avoid areas near energy development. We found no strong difference in habitat variables, such as overstory cover, at the site or reach level. Also, fish abundance was similar among the three river reaches. Otter activity in our study area could have been affected by elevated levels of disturbance surrounding the industrial gas fields, and by potential surface water contamination as indicated by patterns in water conductivity. Continued monitoring of surface water quality in Southwestern Wyoming with the aid of continuously recording devices and sentinel species is warranted.

When goals diverge: Staff consensus and the organizational climate.

PubMed

Melnick, Gerald; Ulaszek, Wendy R; Lin, Hsiu-Ju; Wexler, Harry K

2009-08-01

A sample of correctional officers and prison substance abuse treatment staff collected by the National Criminal Justice Treatment Practices Survey is used to provide an exploratory study of an aspect of organizational culture consisting of consensus (agreement) among prison personnel regarding their beliefs about rehabilitation in the presence of conflicting organizational goals and aspects of the organizational climate important to change. Findings show that among those staff members responding to the survey, the belief in rehabilitation scale mean score was associated with higher levels of organizational commitment, and interdepartmental coordination. However, an hierarchical linear modeling (HLM) analysis that used an index score derived from the standard deviation for staff consensus regarding these same beliefs about rehabilitation produced a different pattern of results, showing that high levels of consensus were associated with job frustration, cynicism towards the ability of the institution to change, and lower levels of organizational commitment. The authors conclude that, although the sample may not express the beliefs of corrections officers or prison-based treatment staff at large, within the sample, consensus appeared to play a unique role in evaluating the effect of divergent goals on organizational climate as it relates to change, and warrants consideration when considering the effects of organizational climate.

Spatial genetic structure and regional demography in the southern torrent salamander: Implications for conservation and management

USGS Publications Warehouse

Miller, Mark P.; Haig, Susan M.; Wagner, R.S.

2006-01-01

The Southern torrent salamander (Rhyacotriton variegatus) was recently found not warranted for listing under the US Endangered Species Act due to lack of information regarding population fragmentation and gene flow. Found in small-order streams associated with late-successional coniferous forests of the US Pacific Northwest, threats to their persistence include disturbance related to timber harvest activities. We conducted a study of genetic diversity throughout this species' range to 1) identify major phylogenetic lineages and phylogeographic barriers and 2) elucidate regional patterns of population genetic and spatial phylogeographic structure. Cytochrome b sequence variation was examined for 189 individuals from 72 localities. We identified 3 major lineages corresponding to nonoverlapping geographic regions: a northern California clade, a central Oregon clade, and a northern Oregon clade. The Yaquina River may be a phylogeographic barrier between the northern Oregon and central Oregon clades, whereas the Smith River in northern California appears to correspond to the discontinuity between the central Oregon and northern California clades. Spatial analyses of genetic variation within regions encompassing major clades indicated that the extent of genetic structure is comparable among regions. We discuss our results in the context of conservation efforts for Southern torrent salamanders.

Internal validity of an anxiety disorder screening instrument across five ethnic groups.

PubMed

Ritsher, Jennifer Boyd; Struening, Elmer L; Hellman, Fred; Guardino, Mary

2002-08-30

We tested the factor structure of the National Anxiety Disorder Screening Day instrument (n=14860) within five ethnic groups (White, Black, Hispanic, Asian, Native American). Conducted yearly across the US, the screening is meant to detect five common anxiety syndromes. Factor analyses often fail to confirm the validity of assessment tools' structures, and this is especially likely for minority ethnic groups. If symptoms cluster differently across ethnic groups, criteria for conventional DSM-IV disorders are less likely to be met, leaving significant distress unlabeled and under-detected in minority groups. Exploratory and confirmatory factor analyses established that the items clustered into the six expected factors (one for each disorder plus agoraphobia). This six-factor model fit the data very well for Whites and not significantly worse for each other group. However, small areas of the model did not appear to fit as well for some groups. After taking these areas into account, the data still clearly suggest more prevalent PTSD symptoms in the Black, Hispanic and Native American groups in our sample. Additional studies are warranted to examine the model's external validity, generalizability to more culturally distinct groups, and overlap with other culture-specific syndromes.

Bevacizumab therapy for adults with recurrent/progressive meningioma: a retrospective series

PubMed Central

Lou, Emil; Sumrall, Ashley L.; Turner, Scott; Peters, Katherine B.; Desjardins, Annick; Vredenburgh, James J.; McLendon, Roger E.; Herndon, James E.; McSherry, Frances; Norfleet, Julie; Friedman, Henry S.

2012-01-01

Intracranial meningiomas are often indolent tumors which typically grow over years to decades. Nonetheless, meningiomas that progress after maximum safe resection and radiation therapy pose a significant therapeutic challenge and effective therapies have yet to be identified. Preclinical studies implicate angiogenesis in the pathophysiology of more aggressive meningiomas, suggesting that anti-angiogenic therapies may be of utility in this setting. We performed a retrospective review of fourteen patients with recurrent meningioma treated at Duke University Medical Center with bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, administered either alone or in combination with chemotherapy. Most patients were heavily pre-treated. Progression-free survival at 6 months was 86 % and was comparable regardless of meningioma grade and whether bevacizumab was administered as monotherapy or in combination with chemotherapy. Most toxicities were mild however single patients developed CNS hemorrhage (grade 1) and intestinal perforation (grade 4), respectively. Bevacizumab can be administered safely to patients with meningioma and appears to be associated with encouraging anti-tumor effect when administered as either a single agent or in combination with chemotherapy. Phase II trials investigating bevacizumab in patients with progressive/recurrent meningioma are warranted. PMID:22535433

Neuroendocrine Associations Underlying the Persistent Therapeutic Effects of Classic Serotonergic Psychedelics.

PubMed

Schindler, Emmanuelle A D; Wallace, Ryan M; Sloshower, Jordan A; D'Souza, Deepak C

2018-01-01

Recent reports on the effects of psychedelic-assisted therapies for mood disorders and addiction, as well as the effects of psychedelics in the treatment of cluster headache, have demonstrated promising therapeutic results. In addition, the beneficial effects appear to persist well after limited exposure to the drugs, making them particularly appealing as treatments for chronic neuropsychiatric and headache disorders. Understanding the basis of the long-lasting effects, however, will be critical for the continued use and development of this drug class. Several mechanisms, including biological and psychological ones, have been suggested to explain the long-lasting effects of psychedelics. Actions on the neuroendocrine system are some such mechanisms that warrant further investigation in the study of persisting psychedelic effects. In this report, we review certain structural and functional neuroendocrinological pathologies associated with neuropsychiatric disorders and cluster headache. We then review the effects that psychedelic drugs have on those systems and provide preliminary support for potential long-term effects. The circadian biology of cluster headache is of particular relevance in this area. We also discuss methodologic considerations for future investigations of neuroendocrine system involvement in the therapeutic benefits of psychedelic drugs.

Attention Bias Modification (ABM): Review of Effects of Multisession ABM Training on Anxiety and Threat-Related Attention in High-Anxious Individuals

PubMed Central

Mogg, Karin; Waters, Allison M.; Bradley, Brendan P.

2017-01-01

Attention bias modification (ABM) aims to reduce anxiety by reducing attention bias (AB) to threat; however, effects on anxiety and AB are variable. This review examines 34 studies assessing effects of multisession-ABM on both anxiety and AB in high-anxious individuals. Methods include ABM-threat-avoidance (promoting attention-orienting away from threat), ABM-positive-search (promoting explicit, goal-directed attention-search for positive/nonthreat targets among negative/threat distractors), and comparison conditions (e.g., control-attention training combining threat-cue exposure and attention-task practice without AB-modification). Findings indicate anxiety reduction often occurs during both ABM-threat-avoidance and control-attention training; anxiety reduction is not consistently accompanied by AB reduction; anxious individuals often show no pretraining AB in orienting toward threat; and ABM-positive-search training appears promising in reducing anxiety. Methodological and theoretical issues are discussed concerning ABM paradigms, comparison conditions, and AB assessment. ABM methods combining explicit goal-directed attention-search for nonthreat/positive information and effortful threat-distractor inhibition (promoting top-down cognitive control during threat-cue exposure) warrant further evaluation. PMID:28752017

Experiences of pregnant women attending a lullaby programme in Limerick, Ireland: a qualitative study.

PubMed

Carolan, Mary; Barry, Maebh; Gamble, Mary; Turner, Kathleen; Mascareñas, Oscar

2012-06-01

to explore women's experience of singing lullabies in pregnancy and their understanding of possible benefits for themselves and their infants. over four group sessions with musicians, six pregnant women, all expecting their first baby, learnt to sing three lullabies. Qualitative semi-structured interviews were conducted approximately three months after the birth to capture the women's experiences. Participants were recruited at antenatal classes at a metropolitan maternity hospital in Ireland. The women enjoyed participation in the lullaby project and all felt it benefited them and their babies. Themes uncovered included: (1) beyond words: music and the articulation of deep emotion; (2) a balm for the soul: the power and pleasure of beautiful music; and (3) music and the facilitation of infant development. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTISE: Singing lullabies in pregnancy had a soothing and calming effect and was a pleasant experience for participants. It was also an emotional experience and appeared to facilitate the expression of difficult emotion such as fear and anxiety. This effect is likely to have a significant and positive impact on well-being for pregnant women and as such warrants further exploration. Copyright © 2011 Elsevier Ltd. All rights reserved.

Economic Impact of Hearing Loss and Reduction of Noise-Induced Hearing Loss in the United States.

PubMed

Neitzel, Richard L; Swinburn, Tracy K; Hammer, Monica S; Eisenberg, Daniel

2017-01-01

Hearing loss (HL) is pervasive and debilitating, and noise-induced HL is preventable by reducing environmental noise. Lack of economic analyses of HL impacts means that prevention and treatment remain a low priority for public health and environmental investment. This article estimates the costs of HL on productivity by building on established estimates for HL prevalence and wage and employment differentials between those with and without HL. We estimate that HL affects more than 13% of the working population. Not all HL can be prevented or treated, but if the 20% of HL resulting from excessive noise exposure were prevented, the economic benefit would be substantial-we estimate a range of $58 billion to $152 billion annually, with a core estimate of $123 billion. We believe this is a conservative estimate, because consideration of additional costs of HL, including health care and special education, would likely further increase the benefits associated with HL prevention. HL is costly and warrants additional emphasis in public and environmental health programs. This study represents an important first step in valuing HL prevention-in particular, prevention of noise-induced HL-where new policies and technologies appear promising.

Transcranial magnetic stimulation (TMS) coupled with electroencephalography (EEG): Biomarker of the future.

PubMed

Kimiskidis, V K

2016-02-01

In recent years, a number of novel brain-stimulation techniques have been developed (such as TMS-EEG, TMS-fMRI and TMS-NIRS), yet they remain underutilized in the field of epilepsy. Accumulating evidence suggests that transcranial magnetic stimulation (TMS) combined with electroencephalography (TMS-EEG) is a highly relevant technique for exploration of the pathophysiology of human epilepsies as well as a promising biomarker with diagnostic and prognostic potential. In genetic generalized epilepsies, TMS-EEG has provided pathophysiological insight by revealing quasi-stable, covert states of excitability, a subclass of which is associated with the generation of TMS-induced epileptiform discharges (EDs). In focal epilepsy, TMS-induced EDs were successfully employed to identify the epileptogenic zone. In addition, TMS trains applied during focal EDs can terminate them, and appear to restore the effective connectivity of the brain network significantly altered by EDs. This abortive effect of TMS on EDs may possibly serve as a biomarker of response to invasive neuromodulatory techniques. TMS-EEG-based stimulation paradigms can provide insight into the mechanisms underlying human epilepsies and, thus, warrant further study as diagnostic and prognostic biomarkers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Psychoacoustic influences of the echoing environments of prehistoric art

NASA Astrophysics Data System (ADS)

Waller, Steven J.

2002-11-01

Cave paintings and ancient petroglyphs around the world are typically found in echo rich locations such as caves, canyons, and rocky cliff faces. Analysis of field data shows that echo decibel levels at a large number of prehistoric art sites are higher than those at nondecorated locations. The selection of these echoing environments by the artists appears not to be a mere coincidence. This paper considers the perception of an echoed sound as a psychoacoustic event that would have been inexplicable to ancient humans. A variety of ancient legends from cultures on several continents attribute the phenomenon of echoes to supernatural beings. These legends, together with the quantitative data, strongly implicate echoing as relevant to the artists of the past. The notion that the echoes were caused by spirits within the rock would explain not only the unusual locations of prehistoric art, but also the perplexing subject matter. For example, the common theme of hoofed animal imagery could have been inspired by echoes of percussion noises perceived as hoof beats. Further systematic acoustical studies of prehistoric art sites is warranted. Conservation of the natural acoustic properties of rock art environments--a previously unrecognized need--is urged.

Organochlorines and mercury in osprey eggs from the eastern United States

USGS Publications Warehouse

Audet, D.J.; Scott, D.S.; Wiemeyer, Stanley N.

1992-01-01

Organochlorine and mercury concentrations were determined in Osprey eggs collected from Maryland, Virginia, and Massachusetts during 1986-87. DDE concentrations were significantly different among locations. Median DDE concentrations did not decline significantly in eggs from Glenn L. Martin National Wildlife Refuge, Maryland, between 1973 and 1986. The median DDE residue for eggs from Martin Refuge in 1986 surpassed the value associated with 10% eggshell thinning, but was below the value associated with production of 1.0 young per active nest, a level assumed to represent a stable population. DDD, DDT, dieldrin, PCB, and mercury residues in all eggs appeared insignificant with regard to potential effects on shell thickness or reproduction. DDE and PCB residues were lower in eggs collected in 1986-87 than in those collected in the 1970s for each area. DDD, DDT, and dieldrin were not detected in Martin Refuge eggs in 1986, representing a significant reduction since 1973. DDD, DDT, and dieldrin levels in Massachusetts and Virginia eggs in 1986-87 were similar to those in eggs from the 1970s for each state. Mercury residues in eggs from Martin Refuge may be increasing and although not significant in this study, may warrant future monitoring.

Bisphenol A Effects on Mammalian Oogenesis and Epigenetic Integrity of Oocytes: A Case Study Exploring Risks of Endocrine Disrupting Chemicals

PubMed Central

Eichenlaub-Ritter, Ursula; Pacchierotti, Francesca

2015-01-01

Bisphenol A (BPA), originally developed as a synthetic oestrogen, is nowadays extensively used in the production of polymeric plastics. Under harsh conditions, these plastics may release BPA, which then can leach into the environment. Detectable concentrations of BPA have been measured in most analysed samples of human serum, plasma, or urine, as well as in follicular fluid, foetal serum, and amniotic fluid. Here we summarize the evidence about adverse BPA effects on the genetic and epigenetic integrity of mammalian oocytes. We conclude that increasing evidence supports the notion that low BPA concentrations adversely affect the epigenome of mammalian female germ cells, with functional consequences on gene expression, chromosome dynamics in meiosis, and oocyte development. Specific time windows, during which profound chromatin remodelling occurs and maternal imprints are established or protected, appear particularly vulnerable to epigenetic deregulation by BPA. Transgenerational effects have been also observed in the offspring of BPA-treated rodents, although the epigenetic mechanisms of inheritance still need to be clarified. The relevance of these findings for human health protection still needs to be fully assessed, but they warrant further investigation in both experimental models and humans. PMID:26339634

Low velocity gunshot wounds result in significant contamination regardless of ballistic characteristics.

PubMed

Weinstein, Joseph; Putney, Emily; Egol, Kenneth

2014-01-01

Controversy exists among the orthopedic community regarding the treatment of gunshot injuries. No consistent treatment algorithm exists for treatment of low energy gunshot wound (GSW) trauma. The purpose of this study was to critically examine the wound contamination following low velocity GSW based upon bullet caliber and clothing fiber type found within the injury track. Four types of handguns were fired at ballistic gel from a 10-foot distance. Various clothing materials were applied (denim, cotton, polyester, and wool) circumferentially around the tissue agar in a loose manor. A total of 32 specimens were examined. Each caliber handgun was fired a minimum of 5 times into a gel. Regardless of bullet caliber there was gross contamination of the entire bullet track in 100% of specimens in all scenarios and for all fiber types. Furthermore, as would be expected, the degree of contamination appeared to increase as the size of the bullet increased. Low velocity GSWs result in significant contamination regardless of bullet caliber and jacket type. Based upon our results further investigation of low velocity GSW tracks is warranted. Further clinical investigation should focus on the degree to which debridement should be undertaken.

Donor Predictors of Allograft Utilization and Recipient Outcomes after Heart Transplantation

PubMed Central

Khush, Kiran K.; Menza, Rebecca; Nguyen, John; Zaroff, Jonathan G.; Goldstein, Benjamin A.

2013-01-01

Background Despite a national organ donor shortage and a growing population of patients with end-stage heart disease, the acceptance rate of donor hearts for transplantation is low. We sought to identify donor predictors of allograft non-utilization, and to determine whether these predictors are in fact associated with adverse recipient post-transplant outcomes. Methods and Results We studied a cohort of 1,872 potential organ donors managed by the California Transplant Donor Network from 2001–2008. Forty five percent of available allografts were accepted for heart transplantation. Donor predictors of allograft non-utilization included age>50 years, female sex, death due to cerebrovascular accident, hypertension, diabetes, a positive troponin assay, left ventricular dysfunction and regional wall motion abnormalities, and left ventricular hypertrophy. For hearts that were transplanted, only donor cause of death was associated with prolonged recipient hospitalization post-transplant, and only donor diabetes was predictive of increased recipient mortality. Conclusions While there are many donor predictors of allograft discard in the current era, these characteristics appear to have little effect on recipient outcomes when the hearts are transplanted. Our results suggest that more liberal use of cardiac allografts with relative contraindications may be warranted. PMID:23392789

Methods for measuring utilization of mental health services in two epidemiologic studies

PubMed Central

NOVINS, DOUGLAS K.; BEALS, JANETTE; CROY, CALVIN; MANSON, SPERO M.

2015-01-01

Objectives of Study Psychiatric epidemiologic studies often include two or more sets of questions regarding service utilization, but the agreement across these different questions and the factors associated with their endorsement have not been examined. The objectives of this study were to describe the agreement of different sets of mental health service utilization questions that were included in the American Indian Service Utilization Psychiatric Epidemiology Risk and Protective Factors Project (AI-SUPERPFP), and compare the results to similar questions included in the baseline National Comorbidity Survey (NCS). Methods Responses to service utilization questions by 2878 AI-SUPERPFP and 5877 NCS participants were examined by calculating estimates of service use and agreement (κ) across the different sets of questions. Logistic regression models were developed to identify factors associated with endorsement of specific sets of questions. Results In both studies, estimates of mental health service utilization varied across the different sets of questions. Agreement across the different question sets was marginal to good (κ = 0.27–0.69). Characteristics of identified service users varied across the question sets. Limitations Neither survey included data to examine the validity of participant responses to service utilization questions. Recommendations for Further Research Question wording and placement appear to impact estimates of service utilization in psychiatric epidemiologic studies. Given the importance of these estimates for policy-making, further research into the validity of survey responses as well as impacts of question wording and context on rates of service utilization is warranted. PMID:18767205

Acetylcholinesterase inhibitors for electroconvulsive therapy-induced cognitive side effects: a systematic review.

PubMed

Henstra, Marieke J; Jansma, Elise P; van der Velde, Nathalie; Swart, Eleonora L; Stek, Max L; Rhebergen, Didi

2017-05-01

Electroconvulsive therapy (ECT) is an effective treatment for severe late-life depression; however, ECT-induced cognitive side effects frequently occur. The cholinergic system is thought to play an important role in the pathogenesis. We systematically reviewed the evidence for acetylcholinesterase inhibitors (Ache-I) to prevent or reduce ECT-induced cognitive side effects. A systematic search was performed in Pubmed, EMBASE, PsychINFO, and the Cochrane database to identify clinical trials investigating the effect of Ache-I on ECT-induced cognitive side effects. Key search terms included all synonyms for ECT and Ache-I. Risk of bias assessment was conducted by using the Cochrane Collaboration's tool. Five clinical trials were eligible for inclusion. All studies focused on cognitive functioning as primary endpoint, but assessment of cognitive functioning varied widely in time point of assessment and in cognitive tests that were used. There was also great variety in study medication, route and time of administration and dosages, duration of drug administration, and ECT techniques. Finally, only two out of five studies were considered at low risk of bias. Despite the aforementioned shortcomings, without exception, all studies demonstrated significantly better cognitive performance in individuals treated with Ache-I. Despite large heterogeneity in studies, Ache-I appear to have beneficial effects on ECT-induced cognitive side effects, supporting an association with the cholinergic system in ECT-induced cognitive impairment. Methodological sound studies controlling for putative confounders are warranted. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Topical Vasodilators in Microsurgery: What Is the Evidence?

PubMed

Rinkinen, Jacob; Halvorson, Eric G

2017-01-01

Background  Topical vasodilators are frequently used during free tissue transfer to prevent and treat vasospasm and microvascular thrombosis. A variety of agents have been studied and are available, yet most microsurgeons select an agent based on anecdotal evidence or personal training. Our aim was to review the literature on topical vasodilators so microsurgeons can make more informed decisions about which agent to use. Methods  A systemic review of the literature was performed on PubMed, EMBASE, and Google Scholar using keywords "topical vasodilator," "antispasmodic," "vasospasm," "free flaps," and "microsurgery." Studies were included if they provided a comparative quantitative assessment of topical vasodilators and were written in English. In vitro, in vivo , and clinical studies were included. Results  A total of 15 studies were identified and included in our analysis. The three most common classes of topical vasodilator include local anesthetics, phosphodiesterase inhibitors, and calcium channel blockers (CCBs). Of the most commonly used topical vasodilators, CCBs (nifedipine and verapamil) were most effective followed by papaverine and lidocaine. Conclusion  The most effective topical vasodilators appear to be CCBs including nifedipine, nicardipine, and verapamil. Evidence suggests that these agents are more effective than papaverine and lidocaine solutions that are commonly used. Future research should directly compare individual CCBs to assess the most effective agent. Studies to date have focused on vessels other than those used by microsurgeons, and therefore further studies specific to these vessels are warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A rare disease in an atypical location-Kimura's Disease of the upper extremity.

PubMed

Lam, Alan Cheuk Si; Au Yeung, Rex Kwok Him; Lau, Vince Wing Hang

2015-12-01

Kimura's disease is a rare chronic inflammatory disorder predominantly affecting young Asian male patients, occurring mainly in the head and neck regions. Kimura's disease of the upper extremity is extremely rare, and previous case reports in the literature show similar imaging characteristics with consistent location at the medial epitrochlear region, predominantly with unilateral involvement. We present the first reported case of Kimura's disease affecting the anterolateral aspect of the upper arm, sparing the medial epitrochlear region, illustrating that with typical MR appearance and serology, the involvement of this rare disease in an atypical location still warrants consideration of this diagnosis. There was also bilateral asymmetrical involvement in our patient, suggesting the possibility of a propensity for Kimura's disease affecting the upper extremities to have bilateral involvement, which may necessitate imaging of the clinically asymptomatic contralateral limb in these patients for early lesion identification and treatment.

Change in the diagnosis from classical Hodgkin's lymphoma to anaplastic large cell lymphoma by (18)F flourodeoxyglucose positron emission tomography/computed tomography: Importance of recognising disease pattern on imaging and immunohistochemistry.

PubMed

Senthil, Raja; Mohapatra, Ranjan Kumar; Sampath, Mouleeswaran Koramadai; Sundaraiya, Sumati

2016-01-01

Anaplastic large cell lymphoma (ALCL) is a rare type of nonHodgkin's lymphoma (NHL), but one of the most common subtypes of T-cell lymphoma. It is an aggressive T-cell lymphoma, and some ALCL may mimic less aggressive classical HL histopathlogically. It may be misdiagnosed unless careful immunohistochemical examination is performed. As the prognosis and management of these two lymphomas vary significantly, it is important to make a correct diagnosis. We describe a case who was diagnosed as classical HL by histopathological examination of cervical lymph node, in whom (18)F-flouro deoxyglucose positron emission tomography/computed tomography appearances were unusual for HL and warranted review of histopathology that revealed anaplastic lymphoma kinase-1 negative anaplastic large T-cell lymphoma, Hodgkin-like variant, thereby changing the management.

Reconsidering "evidence" for fast-and-frugal heuristics.

PubMed

Hilbig, Benjamin E

2010-12-01

In several recent reviews, authors have argued for the pervasive use of fast-and-frugal heuristics in human judgment. They have provided an overview of heuristics and have reiterated findings corroborating that such heuristics can be very valid strategies leading to high accuracy. They also have reviewed previous work that implies that simple heuristics are actually used by decision makers. Unfortunately, concerning the latter point, these reviews appear to be somewhat incomplete. More important, previous conclusions have been derived from investigations that bear some noteworthy methodological limitations. I demonstrate these by proposing a new heuristic and provide some novel critical findings. Also, I review some of the relevant literature often not-or only partially-considered. Overall, although some fast-and-frugal heuristics indeed seem to predict behavior at times, there is little to no evidence for others. More generally, the empirical evidence available does not warrant the conclusion that heuristics are pervasively used.

Severe unexpected adverse effects after permanent eye makeup and their management by Q-switched Nd:YAG laser

PubMed Central

Goldman, Alberto; Wollina, Uwe

2014-01-01

Permanent makeup is a cosmetic tattoo that is used to enhance one’s appearance, and which has become more popular among middle-aged and elderly women. A couple of benefits seem to be associated with permanent tattoos in the elderly: saving time (wake up with makeup); poor eyesight (difficult to apply makeup); and saving money. On the other hand, cosmetic tattoos bear the same risks as other tattoo procedures. We report on fading and unintended hyperpigmentation after tattooing on eyebrows and eyelids, and discuss the scientific and anatomical background behind the possible cause. Dermatochalasis may be a possible risk factor for excessive unwanted discolorations. Q-switched neodymium-doped yttrium aluminum garnet laser is an appropriate and safe therapeutic tool that can manage such adverse effects. Consumer protection warrants better information and education of the risks of cosmetic tattoos – in particular, for elderly women. PMID:25143716

Severe unexpected adverse effects after permanent eye makeup and their management by Q-switched Nd:YAG laser.

PubMed

Goldman, Alberto; Wollina, Uwe

2014-01-01

Permanent makeup is a cosmetic tattoo that is used to enhance one's appearance, and which has become more popular among middle-aged and elderly women. A couple of benefits seem to be associated with permanent tattoos in the elderly: saving time (wake up with makeup); poor eyesight (difficult to apply makeup); and saving money. On the other hand, cosmetic tattoos bear the same risks as other tattoo procedures. We report on fading and unintended hyperpigmentation after tattooing on eyebrows and eyelids, and discuss the scientific and anatomical background behind the possible cause. Dermatochalasis may be a possible risk factor for excessive unwanted discolorations. Q-switched neodymium-doped yttrium aluminum garnet laser is an appropriate and safe therapeutic tool that can manage such adverse effects. Consumer protection warrants better information and education of the risks of cosmetic tattoos - in particular, for elderly women.

Definition of mutually optimum NDI and proof test criteria for 2219 aluminum pressure vessels. Volume 1: Methods

NASA Technical Reports Server (NTRS)

Schwartzberg, F. R.; King, R. G.; Todd, P. H., Jr.

1979-01-01

The requirements for proof testing and nondestructive inspection of aluminum pressure vessels were discussed. The following conclusions are (1) lack-of-fusion weld defects are sufficiently tight in the as-welded condition to be considered undetectable; (2) proof-level loads are required to fully open lack-of-fusion weld defects; (3) significant crack opening occurs at subproof levels so that an inspection enhancement loading treatment designed to avoid catastrophic failure is feasible; (4) currently used proof levels for 2219 pressure vessels are adequate for postproof inspection; (5) quantification of defect size and location using collimated ultrasonic pitch-catch techniques appears sufficiently feasible for tankage to warrant developmental work; (6) for short-time single-cycle pressure-vessel applications, postproof inspection is desirable; and (7) for long-term multiple-cycle pressure-vessel applications, postproof inspection is essential for life assurance.

Fixed-base flywheel storage systems for electric-utility applications: An assessment of economic viability and R and D priorities

NASA Astrophysics Data System (ADS)

Olszewski, M.; Steele, R. S.

1983-02-01

Electric utility side meter storage options were assessed for the daily 2 h peaking spike application. The storage options considered included compressed air, batteries, and flywheels. The potential role for flywheels in this application was assessed and research and development (R and D) priorities were established for fixed base flywheel systems. Results of the worth cost analysis indicate that where geologic conditions are favorable, compressed air energy storage (CAES) is a strong competitor against combustion turbines. Existing battery and flywheel systems rated about equal, both being, at best, marginally uncompetitive with turbines. Advanced batteries, if existing cost and performance goals are met, could be competitive with CAES. A three task R and D effort for flywheel development appears warranted. The first task, directed at reducing fabrication coss and increasing performance of a chopped fiber, F-glass, solid disk concept, could produce a competitive flywheel system.

Ethics of emergent information and communication technology applications in humanitarian medical assistance.

PubMed

Hunt, Matthew; Pringle, John; Christen, Markus; Eckenwiler, Lisa; Schwartz, Lisa; Davé, Anushree

2016-07-01

New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid sector. However, ICTs raise ethical questions that warrant attention. Focusing on the context of humanitarian medical assistance, we review key domains of ICT innovation. We then discuss ethical challenges and uncertainties associated with the development and application of new ICTs in humanitarian medical assistance, including avoiding harm, ensuring privacy and security, responding to inequalities, demonstrating respect, protecting relationships, and addressing expectations. In doing so, we emphasize the centrality of ethics in humanitarian ICT design, application and evaluation. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Role of Circadian Rhythms in Potassium Homeostasis

PubMed Central

Gumz, Michelle L.; Rabinowitz, Lawrence

2013-01-01

It has been known for decades that urinary potassium excretion varies with a circadian pattern. In this review, we consider the historical evidence for this phenomenon and present an overview of recent developments in the field. Extensive evidence from the latter part of the last century clearly demonstrates that circadian potassium excretion does not depend on endogenous aldosterone. Of note is the recent discovery that the expression of several renal potassium transporters varies with a circadian pattern that appears to be consistent with substantial clinical data regarding daily fluctuations in urinary potassium levels. We propose the circadian clock mechanism as a key regulator of renal potassium transporters, and consequently renal potassium excretion. Further investigation into the mechanism of regulation of renal potassium transport by the circadian clock is warranted in order to increase our understanding of the clinical relevance of circadian rhythms to potassium homeostasis. PMID:23953800

Poly-paper: a sustainable material for packaging, based on recycled paper and recyclable with paper.

PubMed

Del Curto, Barbara; Barelli, Nadia; Profaizer, Mauro; Farè, Silvia; Tanzi, Maria Cristina; Cigada, Alberto; Ognibene, Giulia; Recca, Giuseppe; Cicala, Gianluca

2016-11-02

Until now, environmental sustainability issues are almost entirely unsolved for packaging materials. With the final aim of finding materials with a single recycling channel, cellulose fiber/poly(vinyl)alcohol composites were investigated. After extrusion and injection molding, samples of composite with different cellulose fiber content (30%, 50% and 70% w/w) were tested. Tensile mechanical tests exhibited an improvement in composite stiffness when the reinforcement content was increased together with a decrease in composite elongation. Solubility tests performed at room temperature and 45°C showed different behavior depending on the water-resistant film applied on the composite (50% cellulose fiber content). In particular, the uncoated composite showed complete solubility after 2 hours, whereas at the same time point, no solubility occurred when a non-water-soluble varnish was used. The proposed composites, named Poly-paper, appear to warrant further investigation as highly sustainable packaging.

A health profile of the Inuit of Nunavik: report of the Santé Québec Health Survey (1992).

PubMed

Jetté, M

1998-01-01

This general survey of health and well-being aimed primarily to provide a comprehensive insight into the health and social situation in Nunavik, with a view to setting up prevention and intervention programs more properly adapted to the needs of the Inuit of Nunavik. The data gathered through the use of questionnaires were combined with the anthropometric and biological readings of some 1,567 Inuit of all ages to generate the survey findings. In essence, the report demonstrated that, as the current Inuit lifestyle, save for the consumption of traditional foods, was setting the stage for the development of several types of illness previously absent from Nunavik, behavioral changes were warranted. Although the Inuit reported few problems of a physical nature, mental health issues appeared challenging. The prevalence of psychological distress, suicidal thoughts, and parasuicides was of sufficient import to justify direct, concerted, and immediate action.

Heart Failure with Recovered EF and Heart Failure with Mid-Range EF: Current Recommendations and Controversies.

PubMed

Unkovic, Peter; Basuray, Anupam

2018-04-03

This review explores key features and potential management controversies in two emerging populations in heart failure: heart failure with recovered ejection fraction (HF-recovered EF) and heart failure with mid-range ejection fraction (HFmrEF). While HF-recovered EF patients have better outcomes than heart failure with reduced ejection fraction (HFrEF), they continue to have symptoms, persistent biomarker elevations, and abnormal outcomes suggesting a continued disease process. HFmrEF patients appear to have features of HFrEF and heart failure with preserved ejection fraction (HFpEF), but have a high prevalence of ischemic heart disease and may represent a transitory phase between the HFrEF and HFpEF. Management strategies have insufficient data to warrant standardization at this time. HF-recovered EF and HFmrEF represent new populations with unmet needs and expose the pitfalls of an EF basis for heart failure classification.

A Comparison of Object and Animal Hoarding

PubMed Central

Frost, Randy O.; Patronek, Gary; Rosenfield, Elizabeth

2011-01-01

Recent research has highlighted the prevalence and harmful consequences of hoarding,[1] and investigators have proposed inclusion of hoarding disorder in DSM-5.[2] An unanswered question about the proposed disorder is whether people who hoard animals would meet diagnostic criteria for it. This paper discusses the similarities and differences between object and animal hoarding. People who hoard animals appear to meet the basic diagnostic criteria for hoarding disorder. Their homes are cluttered, disorganized, and dysfunctional. They have great difficulty relinquishing animals to people who can more adequately care for them, and they form intense attachments (urges to save) that result in significant impairment. However, they differ from people who hoard objects in several ways. These differences are significant enough to warrant comment in the text description accompanying the diagnostic criteria and consideration as a subtype of hoarding disorder. More research is necessary to determine the exact relationship between object and animal hoarding. PMID:21608085

Microelectronics, radiation, and superconductivity.

PubMed Central

Gochfeld, M

1990-01-01

Among the costs of technology are health hazards that face employees and consumers. New advances in the highly competitive field of microelectronics involve exposure to a variety of hazards such as gallium arsenide. Small high-technology industries appear unprepared to invest in health and safety. Although stray electromagnetic fields are not a new development, researchers are beginning to assemble data indicating that such fields pose a significant cancer risk under certain circumstances. Data have been obtained on fields associated with power lines on the one hand and consumer products on the other. Although not conclusive, the data are sufficient to warrant carefully designed research into the risks posed by electromagnetic fields. Because the scientific issues require research, there is a need to make basic social value decisions that will determine which technologies will be developed and which ones may be set aside because of their danger at the present time. PMID:2401267

Meat consumption and pancreatic cancer risk among men and women in the Cancer Prevention Study-II Nutrition Cohort.

PubMed

McCullough, Marjorie L; Jacobs, Eric J; Shah, Roma; Campbell, Peter T; Wang, Ying; Hartman, Terryl J; Gapstur, Susan M

2018-01-01

Prospective cohort studies suggest that red and processed meat consumption is associated with increased risk of pancreatic cancer among men, but not women. However, evidence is limited, and less evidence exists for other types of meat. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios (HR) for the association of meat consumption, by type, with pancreatic cancer risk among 138,266 men and women in the Cancer Prevention Study-II Nutrition Cohort. Diet was assessed at baseline in 1992, and 10 years earlier, at enrollment into the parent CPS-II mortality cohort. 1,156 pancreatic cancers were verified through 2013. Red meat, processed meat, and fish intake at baseline were not associated with pancreatic cancer risk. However, for long-term red and processed meat consumption (highest quartiles in 1982 and 1992, vs. lowest quartiles), risk appeared different in men [hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.90, 1.95] and women (HR 0.72, 95% CI 0.47, 1.10, p heterogeneity by sex = 0.05). Poultry consumption in 1992 was associated with increased pancreatic cancer risk (HR 1.27, 95% CI 1.04, 1.55, p trend = 0.01, top vs. bottom quintile). The associations of meat consumption with pancreatic cancer risk remain unclear and further research, particularly of long-term intake, is warranted.

Behavioral therapy for weight loss in patients with schizophrenia.

PubMed

Ganguli, Rohan

2007-01-01

Compared with the general population, individuals with schizophrenia demonstrate an increased prevalence of obesity. While most antipsychotics are associated with weight gain, certain second-generation antipsychotics (SGAs) appear to be especially problematic. Weight gain and obesity are highly distressing to these patients, can reduce treatment adherence, and may increase the relative risk of serious medical conditions and all-cause premature mortality. The selection of an antipsychotic on the basis of its effectiveness and relative side effect profile is recognized as an important initial consideration in the treatment of schizophrenia. However, less is known regarding the efficacy of dietary, pharmacologic, and behavioral therapy in reducing antipsychotic-related weight gain and obesity. Behavioral therapy, in particular, is understudied, and there are relatively few controlled trials of its effectiveness in reducing SGA-induced weight gain. Although weight loss resulting from behavioral therapy has been observed mostly as a result of effective short-term interventions, controlled behavioral studies do exist to suggest that weight can be controlled long term. In addition, a small pilot study in patients with schizophrenia or schizoaffective disorder recently demonstrated that behavioral therapy that utilizes stepped interventions, involving body weight self-monitoring, diet, and exercise, can prevent weight gain in patients initiating treatment with SGAs. Additional studies of behavioral therapy for long-term weight control in patients with schizophrenia and other forms of severe mental illness are warranted.

Knowledge of TIA among general practitioners and emergency department physicians. A questionnaire survey in a French semi-rural area.

PubMed

Massengo, Serge A; Cisse, M; Guiziou, C; Leray, E; Rajabally, Yusuf A; Edan, G

2013-08-01

Management of transient ischemic attacks (TIAs) is of vital importance in an attempt to prevent stroke. However, suboptimal management still raise concern among general practitioners (GPs) and emergency department (ED) physicians-the first medical contact of most TIA patients. This may relate to their poorly updated knowledge about TIA. The study was designed to assess knowledge of TIA among these non-neurologists. The study was a post-mailed questionnaire survey among GPs and ED physicians. The questionnaire related to selective clinical aspects on TIA. There were a total of 85 respondents for analysis, mostly GPs (n=64; 75.3%), out of 177 mailed physicians. Response rate was 52.7%. Many of these respondents were unaware of the newly proposed TIA definition (59%), unfamiliar with TIA mimics and predictors of post-TIA early stroke recurrence and therefore with the rationales underlying the need of emergency management of TIA. More than one third (39%) were unaware of the relevant national guidelines. Guidelines-aware respondents performed better in most part of the mailed questionnaire. Our results show that poorly updated knowledge about TIA among non-neurologists represents a potential contributing factor to the persisting sub-optimal management of the disorder. Although further studies are needed to confirm this, improved continuous medical education of this group of health care professionals appears warranted. Copyright © 2013 Elsevier B.V. All rights reserved.

An explorative analysis of the recruitment of patients to a randomised controlled trial in adolescents with dental anxiety.

PubMed

Wide Boman, Ulla; Broberg, Anders G; Krekmanova, Larisa; Staberg, Marie; Svensson, Carina; Robertson, Agneta

2014-01-01

Randomised controlled trials (RCTs) are considered to provide the most reliable evidence on the efficacy of interventions. The aim of this study was to describe the recruitment process of an RCT study set up to evaluate a Cognitive Behavioural Therapy (CBT) intervention programme for adolescent patients with dental anxiety (DA). The participants were recruited from a consecutive sample of adolescent patients (12-19 yrs old) referred for DA to a specialised pediatric dentistry clinic. Age, gender, and reason for referral were recorded for the possible eligible patients as part of the drop-out analysis of the recruitment process. Participants were then randomized to the intervention (CBT integrated with dental treatment) or control (adapted dental treatment) condition. In the recruitment process, 138 possible eligible patients met inclusion criteria, of these 55 were enrolled, 44 declined participation and 39 patients were excluded.The patients enrolled in the RCT did not differ from the non-participants with regard to age, gender or cause of referral. As a result of difficulties in the recruitment process, the study period was extended. The considerable proportion of non-participants as evident from the recruitment process may pose a threat to the external validity of the clinical trial. From a clinical perspective, the reasons for the lack of motivation to participate in behavioural interventions and the failure to appear warrant further investigation.

The Association of Serum Levels of Brain-Derived Neurotrophic Factor with the Occurrence of and Recovery from Delirium in Older Medical Inpatients.

PubMed

Williams, John; Finn, Karen; Melvin, Vincent; Meagher, David; McCarthy, Geraldine; Adamis, Dimitrios

2017-01-01

Limited studies of the association between BDNF levels and delirium have given inconclusive results. This prospective, longitudinal study examined the relationship between BDNF levels and the occurrence of and recovery from delirium. Participants were assessed twice weekly using MoCA, DRS-R98, and APACHE II scales. BDNF levels were estimated using an ELISA method. Delirium was defined with DRS-R98 (score > 16) and recovery from delirium as ≥2 consecutive assessments without delirium prior to discharge. We identified no difference in BDNF levels between those with and without delirium. Excluding those who never developed delirium ( n = 140), we examined the association of BDNF levels and other variables with delirium recovery. Of 58 who experienced delirium, 39 remained delirious while 19 recovered. Using Generalized Estimating Equations models we found that BDNF levels (Wald χ 2 = 7.155; df: 1, p = 0.007) and MoCA (Wald χ 2 = 4.933; df: 1, p = 0.026) were associated with recovery. No significant association was found for APACHE II, dementia, age, or gender. BDNF levels do not appear to be directly linked to the occurrence of delirium but recovery was less likely in those with continuously lower levels. No previous study has investigated the role of BDNF in delirium recovery and these findings warrant replication in other populations.

Learners' perspective: where and when pre-residency trainees learn more to achieve their core clinical competencies.

PubMed

Ahn, Eusang; Ahn, Ducksun; Lee, Young-Mee

2016-12-01

While it is known that effective clinical education requires active involvement of its participants, regular feedback, communication skills and interprofessional training, limited studies have been conducted in Korea that demonstrate how pre-residency trainees acquire their core clinical skills. This is a cross-sectional study of interns and students across a third-tier university hospital in Korea to examine where and when they acquire core clinical skills. A total of 74 students and 91 interns were asked to participate in a closed-ended questionnaire, and 50 participants (20 students and 30 interns) were involved in semistructured individual interviews. The questionnaire was based on the Accreditation Council for Graduate Medical Education core competencies. The majority of core clinical skills were acquired during their rotations in emergency medicine, general surgery, and cardiothoracic surgery. The semistructured interviews revealed that these departments required their trainees to be highly involved and analytical, and participate in clinical discourse. The common factor among the three departments is an environment in which trainees are highly involved in clinical duties, and are expected to make first-contact patient encounters, participate in clinical discourse, interpret investigative results and arrive at their own conclusions. Work-based learning appear to be key to the trends observed, and further study is warranted to determine whether these findings are indicative of true acquisition of clinical competence.

Outcomes of therapeutic TMD interventions on oral health related quality of life: A qualitative systematic review.

PubMed

Song, Yi Lin; Yap, Adrian U-Jin

2018-04-26

This systematic review aims to determine the impact of temporomandibular disorder (TMD) therapeutic interventions on patients' oral health related quality of life (OHRQoL) and to recommend approaches that improve QoL. A systematic search of the literature was performed between January 2007 and October 2017 to identify articles on TMD interventions and OHRQoL. Randomized controlled trials, and retrospective and prospective cohort studies that mentioned dedicated tools for measurement of OHRQoL changes in TMD patients after therapeutic interventions were included. Abstracts of studies that did not mention any form of measurement of OHRQoL in their treatment outcome were excluded. The initial screening yielded 171 articles. After evaluation of abstracts and full text articles, five articles fulfilled all selection criteria and were included. Most TMD treatment interventions seem to improve QoL to some extent, but no single treatment modality can be advocated as the sole approach to managing TMD. Psychotherapy, occlusal appliance therapy, arthrocentesis, and orthodontics/ orthognathic surgery (in subjects with severe malocclusion) appear to improve OHRQoL of TMD patients. Recommendation on the best TMD intervention for improving QoL could not be made due to the diverse TMD subtypes and non-disease specific OHRQoL instruments employed. More studies incorporating TMD-specific OHRQoL measures and targeting explicit TMD subtypes based on internationally accepted diagnostic criteria are warranted in this area of research.

Intermediate-term follow-up of chronically ill patients with digital ischemia treated with peripheral digital sympathectomy.

PubMed

Soberón, José R; Greengrass, Roy A; Davis, William E; Murray, Peter M; Feinglass, Neil

2016-02-01

Digital ischemia is commonly found in patients with scleroderma and has been shown to respond to peripheral digital sympathectomy. While favorable long- and intermediate-term results have been documented in the literature, minimal objective data are available and the mechanism of surgical sympathectomy has not been entirely elucidated. Patients with digital ischemia secondary to Raynaud's phenomenon that had undergone peripheral sympathectomy surgery between 2001 and 2009 were identified and contacted for participation. Radial artery Doppler ultrasound studies were performed and compared to those done at the time of their sympathectomy. Of 11 patients treated over a 9-year period, only two patients were available for detailed follow-up analysis. Four patients were deceased, and two were lost to follow-up. Four of the five remaining patients reported excellent use of the hand and no significant episodes of digital ischemia. Of the two patients studied, functional results were favorable and pain was markedly improved despite worsening of the digital flow resistance over time. We conclude that peripheral digital sympathectomy may provide favorable long-term results in patients with digital ischemia from autoimmune causes, although this intervention should be considered in the early stages once ischemic symptoms manifest. Interestingly, Doppler data did not appear to correlate with functional status and symptom severity in these two patients. Further research, particularly prospective studies, is warranted to guide clinical decisions in this patient population.

Diet Quality and Cancer Outcomes in Adults: A Systematic Review of Epidemiological Studies

PubMed Central

Potter, Jennifer; Brown, Leanne; Williams, Rebecca L.; Byles, Julie; Collins, Clare E.

2016-01-01

Dietary patterns influence cancer risk. However, systematic reviews have not evaluated relationships between a priori defined diet quality scores and adult cancer risk and mortality. The aims of this systematic review are to (1) describe diet quality scores used in cohort or cross-sectional research examining cancer outcomes; and (2) describe associations between diet quality scores and cancer risk and mortality. The protocol was registered in Prospero, and a systematic search using six electronic databases was conducted through to December 2014. Records were assessed for inclusion by two independent reviewers, and quality was evaluated using a validated tool. Sixty-four studies met inclusion criteria from which 55 different diet quality scores were identified. Of the 35 studies investigating diet quality and cancer risk, 60% (n = 21) found a positive relationship. Results suggest no relationship between diet quality scores and overall cancer risk. Inverse associations were found for diet quality scores and risk of postmenopausal breast, colorectal, head, and neck cancer. No consistent relationships between diet quality scores and cancer mortality were found. Diet quality appears to be related to site-specific adult cancer risk. The relationship with cancer mortality is less conclusive, suggesting additional factors impact overall cancer survival. Development of a cancer-specific diet quality score for application in prospective epidemiology and in public health is warranted. PMID:27399671

Dynamic changes in quality of life after three first-line therapies for EGFR mutation-positive advanced non-small-cell lung cancer.

PubMed

Yang, Szu-Chun; Lin, Chien-Chung; Lai, Wu-Wei; Chang, Sheng-Mao; Hwang, Jing-Shiang; Su, Wu-Chou; Wang, Jung-Der

2018-01-01

Three different tyrosine kinase inhibitors have been approved as first-line therapies for epidermal growth factor receptor (EGFR) mutation-positive advanced non-small-cell lung cancer with similar overall survival. This study determined dynamic changes in quality of life (QoL) for patients using these therapies after controlling for potential confounders. From 2011 to 2016, we prospectively assessed the utility values and QoL scores of patients using the EuroQol five-dimension and World Health Organization Quality-of-Life - Brief questionnaires. QoL functions after initiation of treatment were estimated using a kernel-smoothing method. Dynamic changes in major determinants were repeatedly assessed for constructing mixed models. A total of 344 patients were enrolled, with 934 repeated assessments. After controlling for performance status, disease progression, EGFR mutation subtype and other confounders, the mixed models showed significantly lower QoL scores for afatinib versus gefitinib in the physical, psychological and social domains, and 10 facets. The differences seemed to appear 10 months after initiation of treatment. In contrast, there was no significant difference between erlotinib and gefitinib in the scores of all domains and facets. QoL in patients receiving afatinib seemed to be lower than in those receiving gefitinib. Since the sample sizes in this study were relatively small, more studies are warranted to corroborate these results.

Social functioning using direct and indirect measures with children with High Functioning Autism, nonverbal learning disability, and typically developing children.

PubMed

Semrud-Clikeman, Margaret; Fine, Jodene Goldenring; Bledsoe, Jesse

2016-01-01

Social perception is an important underlying foundation for emotional development and overall adaptation. The majority of studies with children with High Functioning Autism (HFA) or nonverbal learning disabilities (NLD) evaluating social functioning have used measures of parent and/or teacher ratings. The present study utilized parent and teacher ratings of behavior as well as executive functioning in addition to direct measures of social perception. Three groups participated in this study (control [n = 38] HFA [n = 36], NLD [n = 31]). Results indicated that the HFA group experienced the most difficulty understanding emotional cues on the direct measure while both the HFA and NLD groups experienced difficulty with nonverbal cues. Significant difficulties were reported on the parent rating scale for sadness and social withdrawal for both clinical groups. Executive functioning was found to be particularly problematic for the clinical groups. The direct social perception measure was highly correlated with the measures of executive functioning and reflects the contribution that executive functions have on social functioning. These findings suggest that the clinical presentation on behavior rating scales may be very similar for children with HFA and NLD. Moreover, it appears that measures of executive functioning are sensitive to the clinical difficulties these groups experience. The findings also suggest there is a commonality in these disorders that warrants further investigation.

Impact of Abdominal Adipose Depots and Race on Risk for Colorectal Cancer: A Case-Control Study

PubMed Central

Gomez-Perez, Sandra L; Chaudhry, Vivek; Mar, Winnie; Patel, Bimal; Fantuzzi, Giamila; Freels, Sally; Braunschweig, Carol

2017-01-01

Visceral (VAT) but not subcutaneous adipose tissue (SAT) is associated with obesity-related diseases including colorectal cancer (CRC). Superficial SAT (SSAT) and deep SAT (DSAT), components of SAT, also appear to independently influence disease risk. These abdominal adipose tissues (AAT) are not extensively studied in connection with CRC and have not been explored in the United States (US) despite known racial variations in body composition. We conducted a case-control study that compared associations between AAT with CRC risk and race of AA and NHW males with incident CRC matched by age, BMI and race (N=158, 79/group). Cross-sectional computed tomography (CT) images were used for assessment of AAT. Overall cases and controls had similar VAT areas (140±192 vs 149±152 cm2, p-value=0.93), however cases had lower SSAT than controls (88±39 vs 112±65 cm2, p<0.01). Among controls, AA had significantly lower VAT (114±168 vs 180±167, p<0.01) than NHW. Conditional logistic regression revealed AA males with greater SSAT had lower odds for CRC (OR: 0.24, 95%CI 0.07–0.85). Our findings indicate VAT does vary between cases and controls by race, however this variation is not a risk factor for CRC. The negative association between CRC and SSAT in AA men warrants further investigation. PMID:28323443

Characteristics of autism spectrum disorder in anorexia nervosa: A naturalistic study in an inpatient treatment programme.

PubMed

Tchanturia, Kate; Adamson, James; Leppanen, Jenni; Westwood, Heather

2017-11-01

Previous research has demonstrated links between anorexia nervosa and autism spectrum disorder however, few studies have examined the possible impact of symptoms of autism spectrum disorder on clinical outcomes in anorexia nervosa. The aim of this study was to examine the association between symptoms of autism spectrum disorder and eating disorders, and other psychopathology during the course of inpatient treatment in individuals with anorexia nervosa. Participants with anorexia nervosa (n = 171) completed questionnaires exploring eating disorder psychopathology, symptoms of depression and anxiety, and everyday functioning at both admission and discharge. Characteristics associated with autism spectrum disorder were assessed using the Autism Spectrum Quotient, short version. Autism spectrum disorder symptoms were significantly positively correlated with eating disorder psychopathology, work and social functioning, and symptoms of depression and anxiety, but not with body mass index. Autism Spectrum Quotient, short version scores remained relatively stable from admission to discharge but there was a small, significant reduction in scores. There was no interaction between time and Autism Spectrum Quotient, short version scores on clinical symptom change. In anorexia nervosa, autism spectrum disorder symptoms appear to be associated with a more severe clinical presentation on admission to inpatient care. Autism spectrum disorder symptoms as assessed by self-report measures may be exacerbated by other mental health psychopathology, which warrants further investigation.

Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients

PubMed Central

Natarajan, Ranganathan; Mallappallil, Mary C.; Norin, Allen J.; Friedman, Eli A.; Saggi, Subodh J.

2014-01-01

Background. Primary goal of this randomized, double-blind, placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins. Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress. Methods. Two 2-month treatment periods separated by 2-month washout and crossover, with physical examinations, venous blood testing, and quality of life questionnaires completed at each visit. Data were analyzed with SAS V9.2. Results. 22 subjects (79%) completed the study. Observed trends were as follows (none reaching statistical significance): decline in WBC count (−0.51 × 109/L, P = 0.057) and reductions in levels of C-reactive protein (−8.61 mg/L, P = 0.071) and total indoxyl glucuronide (−0.11 mg%, P = 0.058). No statistically significant changes were observed in other uremic toxin levels or measures of QOL. Conclusions. Renadyl appeared to be safe to administer to ESRD patients on hemodialysis. Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease. Efficacy could not be confirmed definitively, primarily due to small sample size and low statistical power—further studies are warranted. PMID:25147806

Postpartum Substance Use and Depressive Symptoms: A Review

PubMed Central

Chapman, Shawna L. Carroll; Wu, Li-Tzy

2013-01-01

National survey data suggest that new mothers have high prevalences of alcohol and illicit drug use. Depression correlates with substance use, and new mothers with postpartum depression (PPD) may be at high risk for substance use. Understanding postpartum substance use and its relationship to PPD can inform future research and intervention. A literature search was conducted resulting in 12 studies published from 1999–2012 examining postpartum alcohol use, drug use, or combined postpartum depression and substance use. Postpartum alcohol (prevalence range 30.1%−49%) and drug use (4.5%–8.5%) were lower than use among not pregnant, not postpartum women (41.5%–57.5%; 7.6%–10.6%, respectively) but higher than use among pregnant women (5.4%–11.6%; 3.7%–4.3%, respectively). Correlates of postpartum problem drinking were being unemployed, unmarried, and a cigarette smoker. Prevalence of drug use was highest among white new mothers, followed by Blacks and Hispanics, but Black new mothers appeared at greater risk of drug use. No identified studies examined correlates of postpartum drug use beyond race/ethnicity. Postpartum depressive symptoms were prevalent among postpartum substance users and those with a substance use history (19.7%–46%). The postpartum period is a critical time. Prevalent substance use and the scarcity of studies warrant research to identify means to reduce maternal substance use. PMID:23879459

Physiologically Based Pharmacokinetic and Absorption Modeling for Osmotic Pump Products.

PubMed

Ni, Zhanglin; Talattof, Arjang; Fan, Jianghong; Tsakalozou, Eleftheria; Sharan, Satish; Sun, Dajun; Wen, Hong; Zhao, Liang; Zhang, Xinyuan

2017-07-01

Physiologically based pharmacokinetic (PBPK) and absorption modeling approaches were employed for oral extended-release (ER) drug products based on an osmotic drug delivery system (osmotic pumps). The purpose was to systemically evaluate the in vivo relevance of in vitro dissolution for this type of formulation. As expected, in vitro dissolution appeared to be generally predictive of in vivo PK profiles, because of the unique feature of this delivery system that the in vitro and in vivo release of osmotic pump drug products is less susceptible to surrounding environment in the gastrointestinal (GI) tract such as pH, hydrodynamic, and food effects. The present study considered BCS (Biopharmaceutics Classification System) class 1, 2, and 3 drug products with half-lives ranging from 2 to greater than 24 h. In some cases, the colonic absorption models needed to be adjusted to account for absorption in the colon. C max (maximum plasma concentration) and AUCt (area under the concentration curve) of the studied drug products were sensitive to changes in colon permeability and segmental GI transit times in a drug product-dependent manner. While improvement of the methodology is still warranted for more precise prediction (e.g., colonic absorption and dynamic movement in the GI tract), the results from the present study further emphasized the advantage of using PBPK modeling in addressing product-specific questions arising from regulatory review and drug development.

Evaluation of a computerized cognitive behavioural therapy programme, MindWise (2.0), for adults with mild-to-moderate depression and anxiety.

PubMed

Collins, Sarah; Byrne, Michael; Hawe, James; O'Reilly, Gary

2018-06-01

To investigate the acceptability and utility of a newly developed computerized cognitive behavioural therapy (cCBT) programme, MindWise (2.0), for adults attending Irish primary care psychology services. Adult primary care psychology service users across four rural locations in Ireland were invited to participate in this study. A total of 60 service users participated in the MindWise (2.0) treatment group and compared to 22 people in a comparison waiting list control group. Participants completed pre- and post-intervention outcome measures of anxiety, depression, and work/social functioning. At post-intervention, 25 of 60 people in the MindWise (2.0) condition had fully completed the programme and 19 of 22 people in the waiting list condition provided time 2 data. Relative to those in the control group, the MindWise (2.0) participants reported significantly reduced symptoms of anxiety and no change in depression or work/social functioning. The newly developed cCBT programme, MindWise (2.0), resulted in significant improvements on a measure of anxiety and may address some barriers to accessing more traditional face-to-face mental health services for adults in a primary care setting. Further programme development and related research appears both warranted and needed to lower programme drop-out, establish if gains in anxiety management are maintained over time, and support people in a primary care context with depression. There is a growing evidence base that computerized self-help programmes can assist in a stepped-care approach to adult mental health service provision. These programmes require further development to address issues such as high dropout, the development of equally effective transdiagnostic content, and greater effectiveness in the country of origin. This study evaluated the acceptability and utility of a brief online CBT programme for adults referred due to anxiety or low mood to primary care psychology services in the national health service in Ireland. Results indicate that 42% of people completed the programme and experienced a significant reduction in anxiety but not depression and no improvement in work or social adjustment compared to similar adults on a waiting list for services. This study suggests the programme warrants further development and research and may in time become a useful and suitable intervention within the national health service in Ireland. © 2017 The British Psychological Society.

Left-Turn Bays

DOT National Transportation Integrated Search

1996-05-01

The topic of left-turn bays (left-turn lanes) involves the following three issues: 1.) Warrants; 2.) Bay Length and 3.) Design Details. This discussion paper deals with warrants and bay length -- including queue storage at signalized and unsignalized...

Consumer Feedback to Steer the Future of Assistive Technology Research and Development: A Pilot Study

PubMed Central

Kelleher, Annmarie; Dicianno, Brad E.; Eckstein, Stacy; Schein, Richard; Pearlman, Jonathan

2017-01-01

Objective: The overall objective of this project was to identify consumers' opinions of their needs and wants related to assistive technology (AT) in a systematic and quantitative manner via a questionnaire that can be used to validate existing and establish new research priorities. Methods: This pilot study describes questionnaire development, online implementation, and revisions considered to the questionnaire in preparation for conducting a nationwide survey. Data from a sample (N = 112) are presented. The pilot study was critical to refine the questions and ensure that meaningful information was being collected. Results: It was identified that revisions were warranted to provide more structure and allow for consumers to prioritize AT research efforts. Conclusion: The questionnaire results, although positively in favor of many of the technologies presented, are inconclusive to identify generalizable research priorities, thus expansion to a nationwide population is warranted. PMID:29339885

Implementing a free school-based fruit and vegetable programme: barriers and facilitators experienced by pupils, teachers and produce suppliers in the Boost study

PubMed Central

2014-01-01

Background Multi-component interventions which combine educational and environmental strategies appear to be most effective in increasing fruit and vegetable (FV) intake in adolescents. However, multi-component interventions are complex to implement and often poorly implemented. Identification of barriers and facilitators for implementation is warranted to improve future interventions. This study aimed to explore implementation of two intervention components which addressed availability and accessibility of FV in the multi-component, school-based Boost study which targeted FV intake among Danish 13-year-olds and to identify barriers and facilitators for implementation among pupils, teachers and FV suppliers. Methods We conducted focus group interviews with 111 13-year-olds and 13 teachers, completed class observations at six schools, and conducted telephone interviews with all involved FV suppliers. Interviews were transcribed, coded and analysed using qualitative analytical procedures. Results FV suppliers affected the implementation of the FV programme at schools and thereby pupils’ intake through their timing of delivery and through the quality, quantity and variety of the delivered FV. Teachers influenced the accessibility and appearance of FV by deciding if and when the pupils could eat FV and whether FV were cut up. Different aspects of time acted as barriers for teachers’ implementation of the FV programme: time spent on having a FV break during lessons, time needed to prepare FV and time spent on pupils’ misbehaviour and not being able to handle getting FV. Teacher timing of cutting up and serving FV could turn into a barrier for pupils FV intake due to enzymatic browning. The appearance of FV was important for pupils’ intake, especially for girls. FV that did not appeal to the pupils e.g. had turned brown after being cut up were thrown around as a part of a game by the pupils, especially boys. Girls appreciated the social dimension of eating FV together to a larger extent than boys. Conclusions Limited time and pupils’ misbehaviour were barriers for teachers’ implementation. Establishing FV delivery to schools as a new routine challenged FV suppliers’ implementation. Food aesthetics were important for most pupils’ FV intake while the social dimension of eating FV together seemed more important to girls than boys. Trial registration Current Controlled Trials ISRCTN11666034. PMID:24512278

Implementing a free school-based fruit and vegetable programme: barriers and facilitators experienced by pupils, teachers and produce suppliers in the Boost study.

PubMed

Aarestrup, Anne Kristine; Krølner, Rikke; Jørgensen, Thea Suldrup; Evans, Alexandra; Due, Pernille; Tjørnhøj-Thomsen, Tine

2014-02-11

Multi-component interventions which combine educational and environmental strategies appear to be most effective in increasing fruit and vegetable (FV) intake in adolescents. However, multi-component interventions are complex to implement and often poorly implemented. Identification of barriers and facilitators for implementation is warranted to improve future interventions.This study aimed to explore implementation of two intervention components which addressed availability and accessibility of FV in the multi-component, school-based Boost study which targeted FV intake among Danish 13-year-olds and to identify barriers and facilitators for implementation among pupils, teachers and FV suppliers. We conducted focus group interviews with 111 13-year-olds and 13 teachers, completed class observations at six schools, and conducted telephone interviews with all involved FV suppliers. Interviews were transcribed, coded and analysed using qualitative analytical procedures. FV suppliers affected the implementation of the FV programme at schools and thereby pupils' intake through their timing of delivery and through the quality, quantity and variety of the delivered FV. Teachers influenced the accessibility and appearance of FV by deciding if and when the pupils could eat FV and whether FV were cut up. Different aspects of time acted as barriers for teachers' implementation of the FV programme: time spent on having a FV break during lessons, time needed to prepare FV and time spent on pupils' misbehaviour and not being able to handle getting FV. Teacher timing of cutting up and serving FV could turn into a barrier for pupils FV intake due to enzymatic browning. The appearance of FV was important for pupils' intake, especially for girls. FV that did not appeal to the pupils e.g. had turned brown after being cut up were thrown around as a part of a game by the pupils, especially boys. Girls appreciated the social dimension of eating FV together to a larger extent than boys. Limited time and pupils' misbehaviour were barriers for teachers' implementation. Establishing FV delivery to schools as a new routine challenged FV suppliers' implementation. Food aesthetics were important for most pupils' FV intake while the social dimension of eating FV together seemed more important to girls than boys. Current Controlled Trials ISRCTN11666034.

Life hassles and delusional ideation: Scoping the potential role of cognitive and affective mediators.

PubMed

Kingston, Cara; Schuurmans-Stekhoven, James

2016-12-01

An intertemporal association between major psychological stress and subsequent delusion formation has been established by others. The current study explores (1) whether the stress from life hassles predicts delusional ideation and (2) if so, do self-criticism, self-reassurance, and positive and negative affectivity (PA and NA, respectively) mediate this link. This paper thus aimed to scope-out viable psychological processes involved in the formation of stress-induced delusions. A cross-sectional survey using a non-clinical community sample. Responses (N = 251) to an online community survey were tested via a nonparametric bootstrap sampling approach to examine the effects of multiple mediators. Self-criticism and NA appear to mediate a connection found between life hassles and delusions. A second mediation analysis found that life hassles positively predicts NA directly and indirectly (via self-criticism). NA in turn predicted delusional tendencies. Life events had direct statistical effects on delusions in all models. Neither PA nor self-reassurance mediated the stress-delusion link. Self-criticism and NA seem to be viable mediators worth contemplating when elaborating upon the connection between life hassles and delusions. Compared to self-criticism, NA appears to be the intervening variable most proximal to delusions and explains more variance. Even if these cross-sectional results were interpreted as causative, life hassles and delusions remained directly interconnected in all mediation models (suggesting much of the association remains unexplained). Although the results are theory-consistent, investigations using longitudinal, known-group, and experimental methods are now warranted to establish causation and possible feedback loops - especially from delusion to life hassles. Self-criticism and negative affectivity (NA) mediate the link between stressful life events and delusions suggesting they might actively elicit delusional ideation, whereas self-reassurance and PA (although negatively associated with life hassles) have no unique predictive link to delusions. This study offers initial evidence that NA and self-criticism may be viable clinical intervention targets for early psychosis-sufferers under stress - especially for medically non-compliant and marginal (where drug treatment is not clinically indicated) cases. The clinical efficacy of alleviating self-criticism and/or negative emotional processes in those displaying early psychosis or at high risk appear worthy of exploration using both practice-based case studies and formal experimental research methods. © 2016 The British Psychological Society.

48 CFR 301.603-71 - Waivers to warrant standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of a warrant to an individual who does not fully meet the FAC-C or HHS SAC certification program requirements. Contracting activities shall provide any request for a waiver of the FAC-C program requirements...

48 CFR 301.603-71 - Waivers to warrant standards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of a warrant to an individual who does not fully meet the FAC-C or HHS SAC certification program requirements. Contracting activities shall provide any request for a waiver of the FAC-C program requirements...

48 CFR 301.603-71 - Waivers to warrant standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of a warrant to an individual who does not fully meet the FAC-C or HHS SAC certification program requirements. Contracting activities shall provide any request for a waiver of the FAC-C program requirements...

48 CFR 301.603-71 - Waivers to warrant standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of a warrant to an individual who does not fully meet the FAC-C or HHS SAC certification program requirements. Contracting activities shall provide any request for a waiver of the FAC-C program requirements...

Exploring functional concerns in help-seeking youth: a qualitative study.

PubMed

Cairns, Alice; Dark, Frances; Kavanagh, David; McPhail, Steven

2015-06-01

This study aimed to explore the functional concerns of help-seeking young people 12-25 years of age. Semistructured interviews with n = 10 young people seeking help from a youth mental health clinic were conducted. Data were transcribed verbatim and analysed using content analysis. Results were verified by member checking. Participants identified reasons for seeking help, with the main themes being relationships, emotional management, risk-taking behaviour and difficulties with employment. There appeared to be a difference between the concerns of the older, post-school-age group and the younger participants. Young people are able to identify their functional concerns and reasons for seeking help from mental health services. Understanding the concerns of these young people provides weight to the model of youth-specific mental health services. Future work examining concerns of 12-25 year olds should ensure adequate representation of the older group as their needs and concerns seem to differ from those of younger participants in this study. Post-school-age youth seem to be under-represented in existing literature in this field. However, a limitation with this study is the small sample sizes once the cohort is divided by age. Future studies with a larger, more detailed examination of the needs and concerns of this population are warranted to inform service delivery advancements and clarify the difference in needs between the post-school and current school attendee groups. © 2013 Wiley Publishing Asia Pty Ltd.

Green tea extract-induced lethal toxicity in fasted but not in nonfasted dogs.

PubMed

Wu, Kuei-Meng; Yao, Jiaqin; Boring, Daniel

2011-02-01

Recent chronic toxicity studies performed on green tea extracts in fasted dogs have revealed some unique dose-limiting lethal liver, gastrointestinal, and renal toxicities. Key findings included necrosis of hepatic cells, gastrointestinal epithelia and renal tubules, atrophy of reproductive organs, atrophy and necrosis of hematopoietic tissues, and associated hematological changes. The polyphenol cachetins (a mixture of primarily epigallocatechin gallate [≥55%]; plus up to 10% each of epigallocatechin, epicatechin, and epigallocatechin gallate) appeared to be the causative agents for the observed toxicities because they are the active ingredients of green tea extract studied. Conduct of the study in nonfasted dogs under the same testing conditions and dose levels showed unremarkable results. Assuming both studies were valid, at the identified no observed adverse effect levels (NOAEL) of each study, systemic exposures (based on area under the curve [AUC]) were actually lower in fasted than nonfasted dogs, suggesting that fasting may have rendered the target organ systems potentially more vulnerable to the effects of green tea extract. The toxicity mechanisms that produced lethality are not known, but the results are scientifically intriguing. Because tea drinking has become more popular in the United States and abroad, the mode of action and site of action of green tea extract-induced lethal toxicities during fasting and the role of other phytochemical components of Folia Camellia sinensis (including nonpolyphenol fractions, which are often consumed when whole-leaf products are presented) warrant further investigation.

Justice and Fairness in the Kennedy Krieger Institute Lead Paint Study: the Ethics of Public Health Research on Less Expensive, Less Effective Interventions

PubMed Central

Buchanan, David R.; Miller, Franklin G.

2006-01-01

The Kennedy Krieger lead paint study stirred controversial questions about whether research designed to develop less expensive interventions that are not as effective as existing treatments can be ethically warranted. Critics questioned the social value of such research and alleged that it sanctions a double standard, exploits participants, and is complicit in perpetuating the social injustice. In response, we demonstrate the propriety of conducting research on interventions that can be extended to the population in need by stipulating the limited conditions in which it is ethically warranted and providing fair terms of participation. We contend that the failure to conduct such research causes greater harm, because it deprives disadvantaged populations of the benefits of imminent incremental improvements in their health conditions. PMID:16571697

The monkey puzzle: a systematic review of studies of stress, social hierarchies, and heart disease in monkeys.

PubMed

Petticrew, Mark; Davey Smith, George

2012-01-01

It is often suggested that psychosocial factors, such as stress, or one's social position, may play an important role in producing social gradients in human disease. Evidence in favour of this model of health inequalities has relied, in part, on studies of the health effects of the natural social hierarchies found among non-human primates. This study aimed to assess the strength of this evidence. A systematic review was carried out to identify all studies of psychosocial factors and coronary artery disease (CAD) in non-human primates. We searched databases (MEDLINE, PsycInfo, EMBASE, and Primatelit from inception to November 2010) to identify experimental and observational studies of the impact of social reorganisation, social instability, and disruption of dominance hierarchies on primate CAD outcomes. We also handsearched bibliographies and examined the citations to those studies in public health articles. Fourteen studies were found which presented evidence on CAD and social status and/or psychosocial stress. These suggested that the association between social status and disease may be sex-specific: in female monkeys dominant status may be protective, with subordinate females having a greater extent of atherosclerosis. In male monkeys the reverse may be the case. Overall, non-human primate studies present only limited evidence for an association between social status and CAD, Despite this, there is selective citation of individual non-human primate studies in reviews and commentaries relating to human disease aetiology. Such generalisation of data from monkey studies to human societies does not appear warranted.

The Monkey Puzzle: A Systematic Review of Studies of Stress, Social Hierarchies, and Heart Disease in Monkeys

PubMed Central

Petticrew, Mark; Davey Smith, George

2012-01-01

Background It is often suggested that psychosocial factors, such as stress, or one's social position, may play an important role in producing social gradients in human disease. Evidence in favour of this model of health inequalities has relied, in part, on studies of the health effects of the natural social hierarchies found among non-human primates. This study aimed to assess the strength of this evidence. Methodology/Principal Findings A systematic review was carried out to identify all studies of psychosocial factors and coronary artery disease (CAD) in non-human primates. We searched databases (MEDLINE, PsycInfo, EMBASE, and Primatelit from inception to November 2010) to identify experimental and observational studies of the impact of social reorganisation, social instability, and disruption of dominance hierarchies on primate CAD outcomes. We also handsearched bibliographies and examined the citations to those studies in public health articles. Fourteen studies were found which presented evidence on CAD and social status and/or psychosocial stress. These suggested that the association between social status and disease may be sex-specific: in female monkeys dominant status may be protective, with subordinate females having a greater extent of atherosclerosis. In male monkeys the reverse may be the case. Conclusions/Significance Overall, non-human primate studies present only limited evidence for an association between social status and CAD, Despite this, there is selective citation of individual non-human primate studies in reviews and commentaries relating to human disease aetiology. Such generalisation of data from monkey studies to human societies does not appear warranted. PMID:22470414

ASSESSMENT OF THE POTENTIAL FOR TRANSPORT OF DIOXINS AND CODISPOSED MATERIALS TO GROUNDWATER

EPA Science Inventory

Dioxins are very toxic contaminants and warrant study under a variety of experimental conditions. Studies were performed to evaluate the mobility of several of the dioxins in both soil columns as well as in batch experiments. The studies showed that the amount of chlorination did...

Social Services in the Workplace: Rhetoric vs. Reality.

ERIC Educational Resources Information Center

Wyers, Norman L.; Kaulukukui, Malina

1984-01-01

Cautions that the emergence of industry as an arena for social work practice warrants thoughtful study rather than rhetorical justification. Presents the results of one such study of the need for and nature of social services at the workplace. Discusses questions the study raises for future consideration. (Author/JAC)

The body project 4 all: A pilot randomized controlled trial of a mixed-gender dissonance-based body image program.

PubMed

Kilpela, Lisa Smith; Blomquist, Kerstin; Verzijl, Christina; Wilfred, Salomé; Beyl, Robbie; Becker, Carolyn Black

2016-06-01

The Body Project is a cognitive dissonance-based body image improvement program with ample research support among female samples. More recently, researchers have highlighted the extent of male body dissatisfaction and disordered eating behaviors; however, boys/men have not been included in the majority of body image improvement programs. This study aims to explore the efficacy of a mixed-gender Body Project compared with the historically female-only body image intervention program. Participants included male and female college students (N = 185) across two sites. We randomly assigned women to a mixed-gender modification of the two-session, peer-led Body Project (MG), the two-session, peer-led, female-only (FO) Body Project, or a waitlist control (WL), and men to either MG or WL. Participants completed self-report measures assessing negative affect, appearance-ideal internalization, body satisfaction, and eating disorder pathology at baseline, post-test, and at 2- and 6-month follow-up. Linear mixed effects modeling to estimate the change from baseline over time for each dependent variable across conditions were used. For women, results were mixed regarding post-intervention improvement compared with WL, and were largely non-significant compared with WL at 6-month follow-up. Alternatively, results indicated that men in MG consistently improved compared with WL through 6-month follow-up on all measures except negative affect and appearance-ideal internalization. Results differed markedly between female and male samples, and were more promising for men than for women. Various explanations are provided, and further research is warranted prior to drawing firm conclusions regarding mixed-gender programming of the Body Project. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:591-602). © 2016 Wiley Periodicals, Inc.

Increased risk of peanut allergy in infants of Asian-born parents compared to those of Australian-born parents.

PubMed

Koplin, J J; Peters, R L; Ponsonby, A-L; Gurrin, L C; Hill, D; Tang, M L K; Dharmage, S C; Allen, K J

2014-12-01

Asian infants appear to be over-represented among patients with clinical food allergy in Australia, but this has not been formally examined at the population level. Any difference in prevalence according to parental country of birth may be secondary to modifiable lifestyle factors. We aimed to quantify (i) differences in the prevalence of peanut allergy by parental country of birth and (ii) contribution of measured environmental exposures to these differences. The population-based HealthNuts study in Melbourne, Australia, screened 5276 infants (74% participation) with skin prick tests and sensitized infants underwent food challenge. Of these, 535 had a parent born in East Asia and 574 in UK/Europe. Associations between parents' country of birth and offspring peanut allergy were examined using multiple logistic regression. Compared to infants with two Australian-born parents, peanut allergy was more common among infants with parent/s born in East Asia (OR 3.4, 95% CI 2.2-5.1) but not those with parent/s born in the UK/Europe (OR 0.8, 95% CI 0.4-1.5). Paradoxically rates of allergic disease were lower among Asian parents. A higher prevalence of eczema among infants of Asian parents explained around 30% of the increase in peanut allergy, while differences in dog ownership explained around 18%. The high peanut allergy prevalence among infants of Asian-born parents appears to have occurred in a single generation and was not present among infants with parents migrating from other countries, suggesting gene-environment interactions are important. The role of eczema and microbial exposure in food allergy prevention warrants exploration. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Use of a seismic air gun to reduce survival of nonnative lake trout embryos: A tool for conservation?

USGS Publications Warehouse

Cox, B.S.; Dux, A.M.; Quist, M.C.; Guy, C.S.

2012-01-01

The detrimental impacts of nonnative lake trout Salvelinus namaycush in the western USA have prompted natural resource management agencies in several states to implement lake trout suppression programs. Currently, these programs rely on mechanical removal methods (i.e., gill nets, trap nets, and angling) to capture subadult and adult lake trout. We conducted a study to explore the potential for using high-intensity sound from a relatively small (655.5 cm3 [40 in3]) seismic air gun to reduce survival of lake trout embryos. Lake trout embryos at multiple stages of development were exposed to a single discharge of the seismic air gun at two depths (5 and 15 m) and at two distances from the air gun (0.1 and 2.7 m). Control groups for each developmental stage, distance, and depth were treated identically except that the air gun was not discharged. Mortality in lake trout embryos treated at 0.1 m from the air gun was 100% at 74 daily temperature units in degrees Celsius (TU°C) at both depths. Median mortality in lake trout embryos treated at 0.1 m from the air gun at 207 TU°C (93%) and 267 °C (78%) appeared to be higher than that of controls (49% and 48%, respectively) at 15-m depth. Among the four lake trout developmental stages, exposure to the air gun at 0.1 m resulted in acute mortality up to 60% greater than that of controls. Mortality at a distance of 2.7 m did not appear to differ from that of controls at any developmental stage or at either depth. Our results indicate that seismic air guns have potential as an alternative tool for controlling nonnative lake trout, but further investigation is warranted.

Dating relationships in college students with childhood-onset asthma.

PubMed

Eddington, Angelica R; Mullins, Larry L; Fedele, David A; Ryan, Jamie L; Junghans, Ashley N

2010-02-01

The current study investigated whether differences existed in dating anxiety and fear of intimacy between individuals with childhood-onset asthma and individuals without a chronic illness. Analyses were also conducted to determine if dating anxiety or fear of intimacy were predictors of health-related quality of life in individuals with asthma and healthy controls. Additionally, potential gender differences in dating anxiety and fear of intimacy in individuals with childhood-onset asthma were explored. College undergraduates at least 17 years of age who self-identified as having childhood asthma were randomly matched by age and gender to healthy control participants. Participants completed a demographic form, the Dating Anxiety Scale for Adolescents, the Fear of Intimacy Scale, and the SF-36 Health Survey, a measure of health-related quality of life. There were no significant differences between self-identified participants with asthma and matched healthy controls on the Dating Anxiety Scale or Fear of Intimacy Scale. However, dating anxiety was a significant predictor of mental health-related quality of life in participants with asthma but not in matched health controls. Fear of intimacy was not a significant predictor of mental or physical health-related quality of life in individuals with asthma. In addition, women with asthma endorsed significantly more dating anxiety and lower physical health-related quality of life than males with asthma. College students with asthma appear to experience similar levels of dating anxiety and fear of intimacy than healthy college students; however, their anxiety about dating may have a larger effect on health-related quality of life than healthy individuals. Additional examination of dating and interpersonal relationships among individuals with asthma appears warranted, particularly as it concerns possible gender differences in individuals with childhood-onset asthma.